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P447 Galactomannan lateral flow assay for the diagnosis of invasive Aspergillosis among clinically suspected patients in tertiary care center, Jodhpur, Rajasthan

POSTER SESSION 3, SEPTEMBER 23, 2022, 12:30 PM - 1:30 PM:   INTRODUCTION: Invasive aspergillosis is one of the potentially life-threatening diseases in immunocompromised patients. Early diagnosis and prompt treatment improve patient survival. The gold standard method—conventional microscopy and cult...

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Autores principales: Priya, Hari, Kothari, Nikhil, Jain, Vidhi, Kumar, Deepak, Khichar, Satyendra, Rohila, Amit Kumar, Mokta, Mohan Lal
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9509906/
http://dx.doi.org/10.1093/mmy/myac072.P447
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author Priya, Hari
Kothari, Nikhil
Jain, Vidhi
Kumar, Deepak
Khichar, Satyendra
Rohila, Amit Kumar
Mokta, Mohan Lal
author_facet Priya, Hari
Kothari, Nikhil
Jain, Vidhi
Kumar, Deepak
Khichar, Satyendra
Rohila, Amit Kumar
Mokta, Mohan Lal
author_sort Priya, Hari
collection PubMed
description POSTER SESSION 3, SEPTEMBER 23, 2022, 12:30 PM - 1:30 PM:   INTRODUCTION: Invasive aspergillosis is one of the potentially life-threatening diseases in immunocompromised patients. Early diagnosis and prompt treatment improve patient survival. The gold standard method—conventional microscopy and culture have low sensitivity and a long turnaround time. Serum Galactomannan (GM), a polysaccharide that forms a major component of Aspergillus cell wall and is released by the fungus during invasive growth is established as a reliable biomarker, which is available as Enzyme Linked Immunoassay (ELISA). The limitations of ELISA are high cost, expertise, and difficulty in assay standardization. To overcome these limitations, a qualitative Galactomannan Lateral Flow Assay (GM-LFA) a sandwich immunochromatographic test, recently approved by European CE, is evaluated in our study. OBJECTIVE: To establish the diagnosis of Invasive Aspergillosis according to EORTC/MSGERC Definitions of Invasive Fungal Diseases 2021 guidelines and comparison of GM-LFA with conventional microscopy and culture. METHOD: We performed a retrospective study from October 2021 to March 2022 on serum and bronchoalveolar lavage fluid (BAL) samples. GM-LFA (IMMY sōna Aspergillus Galactomannan LFA) was performed and the results are read after 10 mins with a cube reader according to the manufacturer’s instructions and compared with conventional microscopy and culture. RESULT: During the 6 months study period, 185 samples (14 BAL and 171 Serum) were collected from 148 patients. A total of 17/185 (9.18%) samples from 16 patients were positive by GM-LFA, of those 5 (29.41%) are BAL, and 12 (70.58%) are serum samples. One patient tested positive for Galactomannan on both BAL and serum. Among Assay positive samples, 3/17 (17.64%) samples were positive by microscopy and culture, which grew 2 Aspergillus fumigatus and 1 Aspergillus niger. Treatment details of 5 patients could be traced, of which 4 patients improved clinically and radiologically after Inj. voriconazole and 1 patient died before starting treatment. According to EORTC/MSGERC Definitions of Invasive Fungal Diseases 2021 guidelines, 17 patients belong to the proven and probable Invasive aspergillosis category, in which 16 patients were GM-LFA-positive and the remaining 131 patients had no evidence of invasive aspergillosis disease. CONCLUSION: GM-LFA is a cost-effective, easy, convenient, and rapid procedure. We recommend its use for the diagnosis of invasive Aspergillosis in routine healthcare settings, especially where GM-ELISA is not available or affordable.
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spelling pubmed-95099062022-09-26 P447 Galactomannan lateral flow assay for the diagnosis of invasive Aspergillosis among clinically suspected patients in tertiary care center, Jodhpur, Rajasthan Priya, Hari Kothari, Nikhil Jain, Vidhi Kumar, Deepak Khichar, Satyendra Rohila, Amit Kumar Mokta, Mohan Lal Med Mycol Oral Presentations POSTER SESSION 3, SEPTEMBER 23, 2022, 12:30 PM - 1:30 PM:   INTRODUCTION: Invasive aspergillosis is one of the potentially life-threatening diseases in immunocompromised patients. Early diagnosis and prompt treatment improve patient survival. The gold standard method—conventional microscopy and culture have low sensitivity and a long turnaround time. Serum Galactomannan (GM), a polysaccharide that forms a major component of Aspergillus cell wall and is released by the fungus during invasive growth is established as a reliable biomarker, which is available as Enzyme Linked Immunoassay (ELISA). The limitations of ELISA are high cost, expertise, and difficulty in assay standardization. To overcome these limitations, a qualitative Galactomannan Lateral Flow Assay (GM-LFA) a sandwich immunochromatographic test, recently approved by European CE, is evaluated in our study. OBJECTIVE: To establish the diagnosis of Invasive Aspergillosis according to EORTC/MSGERC Definitions of Invasive Fungal Diseases 2021 guidelines and comparison of GM-LFA with conventional microscopy and culture. METHOD: We performed a retrospective study from October 2021 to March 2022 on serum and bronchoalveolar lavage fluid (BAL) samples. GM-LFA (IMMY sōna Aspergillus Galactomannan LFA) was performed and the results are read after 10 mins with a cube reader according to the manufacturer’s instructions and compared with conventional microscopy and culture. RESULT: During the 6 months study period, 185 samples (14 BAL and 171 Serum) were collected from 148 patients. A total of 17/185 (9.18%) samples from 16 patients were positive by GM-LFA, of those 5 (29.41%) are BAL, and 12 (70.58%) are serum samples. One patient tested positive for Galactomannan on both BAL and serum. Among Assay positive samples, 3/17 (17.64%) samples were positive by microscopy and culture, which grew 2 Aspergillus fumigatus and 1 Aspergillus niger. Treatment details of 5 patients could be traced, of which 4 patients improved clinically and radiologically after Inj. voriconazole and 1 patient died before starting treatment. According to EORTC/MSGERC Definitions of Invasive Fungal Diseases 2021 guidelines, 17 patients belong to the proven and probable Invasive aspergillosis category, in which 16 patients were GM-LFA-positive and the remaining 131 patients had no evidence of invasive aspergillosis disease. CONCLUSION: GM-LFA is a cost-effective, easy, convenient, and rapid procedure. We recommend its use for the diagnosis of invasive Aspergillosis in routine healthcare settings, especially where GM-ELISA is not available or affordable. Oxford University Press 2022-09-20 /pmc/articles/PMC9509906/ http://dx.doi.org/10.1093/mmy/myac072.P447 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of The International Society for Human and Animal Mycology. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Oral Presentations
Priya, Hari
Kothari, Nikhil
Jain, Vidhi
Kumar, Deepak
Khichar, Satyendra
Rohila, Amit Kumar
Mokta, Mohan Lal
P447 Galactomannan lateral flow assay for the diagnosis of invasive Aspergillosis among clinically suspected patients in tertiary care center, Jodhpur, Rajasthan
title P447 Galactomannan lateral flow assay for the diagnosis of invasive Aspergillosis among clinically suspected patients in tertiary care center, Jodhpur, Rajasthan
title_full P447 Galactomannan lateral flow assay for the diagnosis of invasive Aspergillosis among clinically suspected patients in tertiary care center, Jodhpur, Rajasthan
title_fullStr P447 Galactomannan lateral flow assay for the diagnosis of invasive Aspergillosis among clinically suspected patients in tertiary care center, Jodhpur, Rajasthan
title_full_unstemmed P447 Galactomannan lateral flow assay for the diagnosis of invasive Aspergillosis among clinically suspected patients in tertiary care center, Jodhpur, Rajasthan
title_short P447 Galactomannan lateral flow assay for the diagnosis of invasive Aspergillosis among clinically suspected patients in tertiary care center, Jodhpur, Rajasthan
title_sort p447 galactomannan lateral flow assay for the diagnosis of invasive aspergillosis among clinically suspected patients in tertiary care center, jodhpur, rajasthan
topic Oral Presentations
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9509906/
http://dx.doi.org/10.1093/mmy/myac072.P447
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