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Aspergillus Galactomannan Titer as a Diagnostic Marker of Invasive Pulmonary Aspergillosis in Lung Transplant Recipients: A Single-Center Retrospective Cohort Study

Authors
 Eun-Young Kim  ;  Seung-Hyun Yong  ;  Min-Dong Sung  ;  A-La Woo  ;  Young-Mok Park  ;  Ha-Eun Kim  ;  Su-Jin Jung  ;  Song-Yee Kim  ;  Jin-Gu Lee  ;  Young-Sam Kim  ;  Hyo-Chae Paik  ;  Moo-Suk Park 
Citation
 JOURNAL OF FUNGI, Vol.9(5) : 527, 2023-04 
Journal Title
JOURNAL OF FUNGI
Issue Date
2023-04
Keywords
Aspergillus galactomannan antigen ; invasive pulmonary aspergillosis ; lung transplantation
Abstract
Invasive pulmonary aspergillosis (IPA) can occur in immunocompromised patients, and an early detection and intensive treatment are crucial. We sought to determine the potential of Aspergillus galactomannan antigen titer (AGT) in serum and bronchoalveolar lavage fluid (BALF) and serum titers of beta-D-glucan (BDG) to predict IPA in lung transplantation recipients, as opposed to
pneumonia unrelated to IPA. We retrospectively reviewed the medical records of 192 lung transplant recipients. Overall, 26 recipients had been diagnosed with proven IPA, 40 recipients with probable IPA, and 75 recipients with pneumonia unrelated to IPA. We analyzed AGT levels in IPA and non-IPA pneumonia patients and used ROC curves to determine the diagnostic cutoff value. The Serum AGT cutoff value was 0.560 (index level), with a sensitivity of 50%, specificity of 91%, and
AUC of 0.724, and the BALF AGT cutoff value was 0.600, with a sensitivity of 85%, specificity of 85%, and AUC of 0.895. Revised EORTC suggests a diagnostic cutoff value of 1.0 in both serum and BALF AGT when IPA is highly suspicious. In our group, serum AGT of 1.0 showed a sensitivity of 27% and a specificity of 97%, and BALF AGT of 1.0 showed a sensitivity of 60% and a specificity of 95%. The result suggested that a lower cutoff could be beneficial in the lung transplant group. In multivariable analysis, serum and BALF AGT, with a minimal correlation between the two, showed
a correlation with a history of diabetes mellitus.
Files in This Item:
T202302799.pdf Download
DOI
10.3390/jof9050527
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Song Yee(김송이) ORCID logo https://orcid.org/0000-0001-8627-486X
Kim, Young Sam(김영삼) ORCID logo https://orcid.org/0000-0001-9656-8482
Kim, Eun Young(김은영) ORCID logo https://orcid.org/0000-0002-3281-5744
Kim, Ha Eun(김하은)
Park, Moo Suk(박무석) ORCID logo https://orcid.org/0000-0003-0820-7615
Park, Youngmok(박영목) ORCID logo https://orcid.org/0000-0002-5669-1491
Paik, Hyo Chae(백효채) ORCID logo https://orcid.org/0000-0001-9309-8235
Sung, MinDong(성민동) ORCID logo https://orcid.org/0000-0002-5217-8877
Yong, Seung Hyun(용승현)
Woo, Ala(우아라)
Lee, Jin Gu(이진구)
Jeong, Su Jin(정수진) ORCID logo https://orcid.org/0000-0003-4025-4542
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/194265
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