Abstract | BACKGROUND: METHODS: We studied the expression of galactomannan antigen by enzyme immunoassay (EIA) in 990 serum samples from 56 pediatric oncology patients (ages 3 months to 18 years) of whom 17 had proven or probable invasive aspergillosis defined by the European Organization for Research and Treatment of Cancer- Mycoses Study Group criteria. Any sample with a galactomannan EIA Galactomannan index value of > or = 0.5 was considered positive. RESULTS: At least 1 serum sample was positive for 11 of 17 pediatric oncology patients (65.7% sensitivity, 95% confidence interval: 38.3-85.7) with invasive aspergillosis. Galactomannan EIA was positive in 99 of 304 samples from patients with proven or probable invasive aspergillosis, and 7 of 686 (1.0%) samples from 39 control subjects resulted in a positive galactomannan EIA result. At least 1 sample tested positive in 5 of the 39 controls (12.8%, 95% confidence interval: 4.3-27.4). No significant association between accuracy and patient age was observed. Among the 7 evaluable galactomannan-positive patients with IA, the galactomannan EIA produced a positive result before clinical or radiographic evidence of infection in 6 cases, with a lead-time to diagnosis ranging from 1 day to 34 days (median: 10 days). In the remaining case, a positive galactomannan was observed on the same day as diagnosis by non-EIA methods. CONCLUSIONS:
|
Authors | Randall Hayden, Stanley Pounds, Katherine Knapp, Ruta Petraitiene, Robert L Schaufele, Tin Sein, Thomas J Walsh |
Journal | The Pediatric infectious disease journal
(Pediatr Infect Dis J)
Vol. 27
Issue 9
Pg. 815-9
(Sep 2008)
ISSN: 0891-3668 [Print] United States |
PMID | 18703991
(Publication Type: Evaluation Study, Journal Article, Research Support, N.I.H., Intramural, Research Support, Non-U.S. Gov't)
|
Chemical References |
- Antigens, Fungal
- Mannans
- galactomannan
- Galactose
|
Topics |
- Adolescent
- Antigens, Fungal
(blood)
- Aspergillosis
(diagnosis)
- Child
- Child, Preschool
- Galactose
(analogs & derivatives)
- Humans
- Immunocompromised Host
- Immunoenzyme Techniques
- Infant
- Mannans
(blood)
- Neoplasms
(complications)
- Predictive Value of Tests
- Sensitivity and Specificity
- Time Factors
|