DIAGNOSTIC PERFORMANCE OF PCR AND GALACTOMANNAN ANTIGEN TESTING IN RESPIRATORY SPECIMENS FOR DIAGNOSIS OF ASPERGILLOSIS
Keywords:
Aspergillus, aspergillosis, PCR, galactomannan, respiratory specimenAbstract
Introduction: Aspergillosis in immunocompromised individuals is a serious and potentially life-threatening infection. Early diagnosis of aspergillosis is a great diagnostic challenge. Therefore, there is a need for more sensitive methods for early detection of aspergillosis.
Aim: The aim of the study was to compare the diagnostic value of PCR and galactomannan antigen tests performed on respiratory specimens for the diagnosis of aspergillosis.
Material and methods: Respiratory specimens from 125 patients divided into 4 groups, according to EORTC/MSG criteria, were analysed with PCR and galactomannan antigen tests, at the Institute of Microbiology and Parasitology during a period of two years.
Results: PCR performed in respiratory specimens yielded the following sensitivity and specificity percentages in all four groups: 67.86 % and 85.71 %, 72.73 % and 75 %, 40.91 % and 50 %, 50 % and 50 % in all groups, respectively. Sensitivity and specificity of galactomannan antigen assay in respiratory specimens were: 75 % and 57.14 %, 86.36 % and 62.5 %, 81.82 % and 0 %, 80 % and 70.83 % in all 4 groups, respectively.
Conclusion: The findings of our study support the use of galactomannan antigen testing in respiratory specimens for the diagnosis of aspergillosis, noting its potential superiority to PCR in specific cohorts. Although PCR provides optimal sensitivity for early detection and treatment initiation, the greatest diagnostic accuracy is achieved by combining both methods. Therefore, a multimodal diagnostic strategy, integrating galactomannan and PCR testing, is recommended to enhance early detection and guide management, particularly in high-risk patients.
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