Srpski arhiv za celokupno lekarstvo 2012 Volume 140, Issue 5-6, Pages: 290-298
https://doi.org/10.2298/SARH1206290R
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Detection of laboratory biomarkes in haematological and pulmonology patients at high risk for aspergillosis
Ratkov Eleonora (Referentna laboratorija za uzročnike mikoza, Institut za mikrobiologiju i imunologiju, Medicinski fakultet, Beograd)
Vidović Ana (Klinika za hematologiju, Klinički centar Srbije, Beograd + Medicinski fakultet, Beograd)
Minić Predrag (Medicinski fakultet, Beograd + Institut za zdravstvenu zaštitu majke i deteta Srbije „Dr Vukan Čupić”, Beograd)
Janić Dragana (Medicinski fakultet, Beograd + Odeljenje za hematoonkologiju, Univerzitetska dečja klinika, Beograd)
Šipetić-Grujičić Sandra (Institut za epidemiologiju, Medicinski fakultet, Beograd)
Džamić Aleksandar (Referentna laboratorija za uzročnike mikoza, Institut za mikrobiologiju i imunologiju, Medicinski fakultet, Beograd)
Arsić-Arsenijević Valentina (Referentna laboratorija za uzročnike mikoza, Institut za mikrobiologiju i imunologiju, Medicinski fakultet, Beograd)
Introduction. During the past decades a dramatic increase in the incidence of
invasive fungal diseases, especially invasive aspergillosis has been
observed. Undiagnosed and diagnosed late invasive aspergillosis is followed
by lethality of up to 90%. Detection of early laboratory biomarkers
(galactomannan and anti-Aspergillus antibodies) contributes to early
diagnosis and is used for screening, as well as for monitoring therapy of
aspergillosis. Objective. The aim was to evaluate usefulness of “non-culture”
methods (galactomannan and anti-Aspergillus antibodies IgA, IgM and IgG) for
early diagnosis of aspergillosis in high-risk patients. Methods. Prospective
two-year study involved 262 high-risk patients for aspergillosis. In
pulmonology and haematology patients (adults and children) blood samples were
tested on galactomannan and anti-Aspergillus antibodies. Results. Early
laboratory biomarkers were statistically significantly higher in pulmonology
patients (p=0.00033). However, in haematological patients galactomannan was a
more frequently positive finding, while in pulmonology patients it was the
finding of anti-Aspergillus antibodies. It is interesting that, despite the
possible immunosuppression, in about 1/3 of haematological patients
anti-Aspergillus antibodies were confirmed. Conclusion. Early diagnosis and
treatment of aspergillosis represent both clinical and laboratory problem.
Nowadays, the application of new “non-culture” methods is of particular
importance for the outcome of aspergillosis. Clinical features, laboratory
findings of biomarkers and their correct interpretation significantly
increase the possibility of timely implementation of appropriate therapy. In
this regard, the new organization of reference laboratory for medical
mycology has significantly improved the outcome of aspergillosis in high-risk
patients in our country. However, further investigations, implementation of
European standards and introduction of new diagnostic methods are necessary
in this field.
Keywords: aspergillosis, early laboratory diagnosis, galactomannan, anti-Aspergillus antibodies, high-risk patients