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Evaluation of a commercial quantitative Aspergillus fumigatus-specific IgM assay for the diagnosis of invasive pulmonary aspergillosis.

Abstract Invasive pulmonary aspergillosis (IPA) is a common fungal infection with high mortality rates in immunocompromised patients. Early diagnosis of IPA is still challenging because of its nonspecific clinical symptoms and radiological presentations.To evaluate the clinical value of a commercial Aspergillus fumigates-specific IgM antibody assay in diagnosis of IPA, a multicenter prospective study was performed in 12 hospitals in Zhejiang Province, China, from January 1 to December 31, 2016.A total of 59 patients were enrolled in this study, including 30 IPA and 29 non-IPA patients. The sensitivities of IgM assay were 30.0%, 26.7%, 23.3%, and 20.0%, and the specificities were 79.3%, 86.2%, 86.2%, and 96.6% at the cutoff values of 50, 60, 70 and 80 AU/mL, respectively. The area under the curve of the IgM assay revealed by the receiver-operating characteristic analysis was 0.511 in the IPA cases. This study is the first to evaluate the clinical performance of a commercial A. fumigatus-specific IgM antibody assay that uses envelopes galactomannan extracted from A. fumigatus as the sole antigen in diagnosis of IPA.In conclusion, the A. fumigatus-specific IgM antibody assay has limited value and should not be a prior recommendation for IPA diagnosis.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 29390575
OWN - NLM
STAT- MEDLINE
DCOM- 20180212
LR  - 20180212
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 51
DP  - 2017 Dec
TI  - Evaluation of a commercial quantitative Aspergillus fumigatus-specific IgM assay 
      for the diagnosis of invasive pulmonary aspergillosis.
PG  - e9436
LID - 10.1097/MD.0000000000009436 [doi]
AB  - Invasive pulmonary aspergillosis (IPA) is a common fungal infection with high
      mortality rates in immunocompromised patients. Early diagnosis of IPA is still
      challenging because of its nonspecific clinical symptoms and radiological
      presentations.To evaluate the clinical value of a commercial Aspergillus
      fumigates-specific IgM antibody assay in diagnosis of IPA, a multicenter
      prospective study was performed in 12 hospitals in Zhejiang Province, China, from
      January 1 to December 31, 2016.A total of 59 patients were enrolled in this
      study, including 30 IPA and 29 non-IPA patients. The sensitivities of IgM assay
      were 30.0%, 26.7%, 23.3%, and 20.0%, and the specificities were 79.3%, 86.2%,
      86.2%, and 96.6% at the cutoff values of 50, 60, 70 and 80 AU/mL, respectively.
      The area under the curve of the IgM assay revealed by the receiver-operating
      characteristic analysis was 0.511 in the IPA cases. This study is the first to
      evaluate the clinical performance of a commercial A. fumigatus-specific IgM
      antibody assay that uses envelopes galactomannan extracted from A. fumigatus as
      the sole antigen in diagnosis of IPA.In conclusion, the A. fumigatus-specific IgM
      antibody assay has limited value and should not be a prior recommendation for IPA
      diagnosis.
CI  - Copyright (c) 2017 The Authors. Published by Wolters Kluwer Health, Inc. All
      rights reserved.
FAU - Yao, Yake
AU  - Yao Y
AD  - Department of Respiratory.
FAU - Zhou, Hua
AU  - Zhou H
AD  - Department of Respiratory.
FAU - Shen, Yihong
AU  - Shen Y
AD  - Department of Respiratory.
FAU - Yang, Qing
AU  - Yang Q
AD  - State Key Lab for Diagnostic and Treatment of Infectious Diseases, Collaborative 
      Innovation Center for Diagnosis and Treatment of Infectious Disease, the First
      Affiliated Hospital of College of Medicine, Zhejiang University.
FAU - Ye, Jian
AU  - Ye J
AD  - Department of Respiratory, Hangzhou First People's Hospital.
FAU - Lu, Guohua
AU  - Lu G
AD  - Department of Respiratory.
FAU - Fu, Yiqi
AU  - Fu Y
AD  - Department of Respiratory.
FAU - Lou, Haiyan
AU  - Lou H
AD  - Department of Radiology, the First Affiliated Hospital.
FAU - Yu, Yunsong
AU  - Yu Y
AD  - Department of Infectious Diseases, Sir Run Run Shaw Hospital, School of Medicine,
      Zhejiang University, Hangzhou, Zhejiang, China.
FAU - Zhou, Jianying
AU  - Zhou J
AD  - Department of Respiratory.
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Multicenter Study
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Immunoglobulin M)
RN  - 0 (Reagent Kits, Diagnostic)
SB  - AIM
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Aspergillus fumigatus/*immunology
MH  - Female
MH  - Humans
MH  - Immunoglobulin M/*immunology
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - Pulmonary Aspergillosis/*diagnosis/immunology/microbiology
MH  - Reagent Kits, Diagnostic
MH  - Sensitivity and Specificity
MH  - Young Adult
PMC - PMC5758277
EDAT- 2018/02/03 06:00
MHDA- 2018/02/13 06:00
CRDT- 2018/02/03 06:00
PHST- 2018/02/03 06:00 [entrez]
PHST- 2018/02/03 06:00 [pubmed]
PHST- 2018/02/13 06:00 [medline]
AID - 10.1097/MD.0000000000009436 [doi]
AID - 00005792-201712220-00162 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2017 Dec;96(51):e9436. doi: 10.1097/MD.0000000000009436.