The misleading effect of serum galactomannan testing in high-risk haematology patients receiving prophylaxis with micafungin

Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases
A VenaP Munoz

Abstract

To investigate the performance of the routine serum galactomannan (sGM) assay in the diagnosis of invasive aspergillosis (IA) in high-risk haematology patients receiving prophylaxis with micafungin. Retrospective study including all haematological patients who received prophylaxis with micafungin during high-risk IA episodes (neutropenic patients after chemotherapy for acute myeloid leukaemia/myelodysplastic syndrome; allogeneic haematopoietic stem-cell transplantation during early neutropenic phase or graft-versus-host disease requiring high prednisone doses) and for whom at least one sGM result was available. Episodes were classified as follows: true-positive (positive GM in the context of IA), false-positive (positive GM result in patients who had no evidence of IA), true-negative (negative GM test results and no IA), or false-negative (negative GM test in the context of IA). Non-evaluable patients were excluded. Among 146 evaluable episodes, four were true-positive in the context of probable breakthrough IA (incidence of breakthrough IA, 2.7%); 111/146 high-risk episodes (76%) were considered true-negative and 31/146 (21.2%) were considered false-positive. No false-negative episodes were detected. All but one of the false-p...Continue Reading

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Citations

Jun 7, 2017·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·C Lass-Florl
Nov 11, 2017·Expert Review of Anti-infective Therapy·Daniele Roberto GiacobbeMalgorzata Mikulska
Jun 25, 2019·Medical Mycology·Ana Fernández-CruzPatricia Muñoz
Mar 12, 2020·Open Forum Infectious Diseases·Euijin ChangMyoung-Don Oh
Feb 7, 2020·Infectious Diseases and Therapy·Antonio VenaEmilio Bouza
Oct 15, 2020·Journal of Fungi·Jeffrey D JenksUNKNOWN European Confederation of Medical Mycology (ECMM) Council Investigators
Dec 23, 2021·Internal Medicine Journal·Benjamin W TehUNKNOWN Australasian Antifungal Guidelines Steering Committee

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