Abstract
Our aim was to evaluate the performance of two galactomannan (GM) assays (Platelia Aspergillus EIA, Bio-Rad® , and Aspergillus GM LFA, IMMY® ) in tracheal aspirate (TA) samples of consecutive critically ill patients with COVID-19. We included critically ill patients, performed GM-EIA and GM-Lateral Flow Assay (GM-LFA) in TA and followed them until development of COVID-19-associated pulmonary aspergillosis (CAPA) or alternate diagnosis. CAPA was defined according to the modified AspICU criteria in patients with SARS-CoV-2 infection. We estimated sensitivity, specificity, positive and negative predictive values for GM-EIA, GM-LFA, the combination of both or either positive results for GM-EIA and GM-LFA. We explored accuracy using different breakpoints, through ROC analysis and Youden index to identify the optimal cut-offs. We described antifungal treatment and 30-day mortality. We identified 14/144 (9.7%) patients with CAPA, mean age was 50.35 (SD 11.9), the median time from admission to CAPA was 8 days; 28.5% received tocilizumab and 30-day mortality was 57%. ROC analysis and Youden index identified 2.0 OD as the best cut-off, resulting in sensitivity and specificity of 57.1% and 81.5% for GM-EIA and 60% and 72.6% for GM-LFA, re...Continue Reading
References
Jun 1, 1995·American Journal of Respiratory and Critical Care Medicine·C H MarquetteA B Tonnel
Aug 2, 2003·The New England Journal of Medicine·Huijun WangWei Kang
Jul 24, 2004·Modern Pathology : an Official Journal of the United States and Canadian Academy of Pathology, Inc·David M HwangJagdish Butany
Nov 17, 2004·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Rocus R KlontPaul E Verweij
Aug 26, 2011·Rheumatology·Veronika R LangJochen Zwerina
Apr 21, 2012·American Journal of Respiratory and Critical Care Medicine·Stijn I BlotUNKNOWN AspICU Study Investigators
Mar 4, 2014·Pathogens and Disease·Shauna Milne-PriceVincent J Munster
Mar 29, 2014·Journal of Clinical Microbiology·M HoeniglD Buchheidt
Mar 31, 2016·The Journal of Infection·J FortúnJ M Aguado
Oct 21, 2016·Annals of Translational Medicine·Maya HitesFabio Silvio Taccone
Jul 18, 2018·Journal of Critical Care·T BochD Buchheidt
Aug 5, 2018·The Lancet. Respiratory Medicine·Alexander F A D SchauwvliegheUNKNOWN Dutch-Belgian Mycosis study group
Nov 6, 2018·Mycoses·Dimitrios FarmakiotisSophia Koo
Dec 20, 2018·Mycoses·Jeffrey D JenksMartin Hoenigl
Apr 3, 2019·Antimicrobial Agents and Chemotherapy·M AignerM Lackner
Jul 11, 2019·Medical Mycology·Toine MercierJohan Maertens
Dec 6, 2019·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·J Peter DonnellyPeter G Pappas
Jan 30, 2020·Euro Surveillance : Bulletin Européen Sur Les Maladies Transmissibles = European Communicable Disease Bulletin·Victor M CormanChristian Drosten
Apr 28, 2020·Mycoses·Philipp KoehlerAlexander Shimabukuro-Vornhagen
May 13, 2020·American Journal of Respiratory and Critical Care Medicine·Andreas L E van ArkelRobbert G Bentvelsen
May 24, 2020·The Lancet. Respiratory Medicine·Alexandre AlanioBruno Mégarbane
Jun 26, 2020·Mycoses·Nosheen NasirKauser Jabeen
Jul 1, 2020·Journal of Fungi·Amir ArastehfarMartin Hoenigl
Jul 14, 2020·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·Frederic LamothJean-Luc Pagani
Jul 25, 2020·The European Respiratory Journal·Darius Armstrong-JamesMatthew C Fisher
Citations
Mar 13, 2021·Infection·Woon H ChongAmit Chopra
Mar 25, 2021·Mycoses·Jeffrey D JenksMartin Hoenigl
Apr 26, 2021·Mycoses·Hayato MitakaParu Patrawalla
Jun 1, 2021·Mycoses·Shreya SinghShivaprakash M Rudramurthy
Jun 24, 2021·Intensive Care Medicine·Paul E VerweijIgnacio Martin-Loeches
Jul 1, 2021·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·Arnaud FekkarFrederic Lamoth
Jul 13, 2021·Mycoses·Martin HoeniglJeffrey D Jenks
Aug 7, 2021·Journal of Fungi·María Guadalupe Frías-De-LeónErick Martínez-Herrera
Jun 19, 2021·Mycoses·Grégoire PasquierEric Dannaoui
Sep 2, 2021·Intensive Care Medicine·Juergen PrattesUNKNOWN ECMM-CAPA Study Group
Sep 17, 2021·Critical Care : the Official Journal of the Critical Care Forum·Stefan HatzlGernot Schilcher
Nov 18, 2021·Clinical Microbiology Reviews·Fabián SalazarAdilia Warris