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Article

Sputum Galactomannan Has Utility in the Diagnosis of Chronic Pulmonary Aspergillosis

1
Laboratory Medicine, Department of Microbiology, Royal Brompton Hospital, Guy’s and St Thomas’ NHS Foundation Trust, London SW3 6NP, UK
2
Department of Respiratory Medicine, Royal Brompton Hospital, Guy’s and St Thomas’ NHS Foundation Trust, London SW3 6NP, UK
3
MRC Centre of Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College, London SW7 2AZ, UK
4
MRC Centre for Molecular Bacteriology and Infection, Department of Infectious Diseases, Imperial College London, London SW7 2BX, UK
*
Author to whom correspondence should be addressed.
Academic Editors: Célia F. Rodrigues and Natália Cruz-Martins
J. Fungi 2022, 8(2), 188; https://doi.org/10.3390/jof8020188
Received: 29 January 2022 / Revised: 10 February 2022 / Accepted: 11 February 2022 / Published: 14 February 2022
(This article belongs to the Topic Infectious Diseases)
Diagnosis of pulmonary aspergillosis (PA), a fungal disease caused by Aspergillus species, is challenging since symptoms are unspecific. The galactomannan (antigen secreted by Aspergillus species) test in bronchoalveolar lavage (BAL) fluid is a valuable diagnostic adjunct test in the diagnosis of PA. However, BAL collection is invasive and may not be suitable to severely ill patients. Sputum is non-invasive, easily collected, and lung specific and may be an alternative to BAL. The aim of this research was to retrospectively evaluate the utility of sputum galactomannan in the diagnosis of pulmonary aspergillosis in patients with chronic respiratory diseases and to estimate the sputum galactomannan cut-off value. We collected data from patients with clinical suspicion of pulmonary aspergillosis who had sputum galactomannan, culture, and Aspergillus IgG tests performed within four weeks. Sputum galactomannan was validated against the clinical diagnosis of aspergillosis, Aspergillus culture, and Aspergillus IgG tests. In total, 218 patients met inclusion criteria. Overall, sputum GM showed satisfactory agreement with clinical diagnosis of aspergillosis, Aspergillus culture, and Aspergillus IgG. When a receiver operating characteristic curve was constructed using Aspergillus culture/IgG and clinical diagnosis, the same cut-off (CO) of 0.71 (AUC: 0.83; CI: 0.69–0.86, p < 0.001) was determined. Against clinical diagnosis, sputum GM gave sensitivity and specificity of 70% and 71%, respectively. Sensitivity of 77% and specificity of 78% were found when sputum GM was evaluated against Aspergillus culture/IgG. In conclusion, this study showed that sputum galactomannan antigen testing has utility in the diagnosis of chronic forms of pulmonary aspergillosis and further prospective validation is indicated. View Full-Text
Keywords: Aspergillus species; pulmonary aspergillosis; galactomannan; sputum; diagnosis Aspergillus species; pulmonary aspergillosis; galactomannan; sputum; diagnosis
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MDPI and ACS Style

Nuh, A.; Ramadan, N.; Shah, A.; Armstrong-James, D. Sputum Galactomannan Has Utility in the Diagnosis of Chronic Pulmonary Aspergillosis. J. Fungi 2022, 8, 188. https://doi.org/10.3390/jof8020188

AMA Style

Nuh A, Ramadan N, Shah A, Armstrong-James D. Sputum Galactomannan Has Utility in the Diagnosis of Chronic Pulmonary Aspergillosis. Journal of Fungi. 2022; 8(2):188. https://doi.org/10.3390/jof8020188

Chicago/Turabian Style

Nuh, Ali, Newara Ramadan, Anand Shah, and Darius Armstrong-James. 2022. "Sputum Galactomannan Has Utility in the Diagnosis of Chronic Pulmonary Aspergillosis" Journal of Fungi 8, no. 2: 188. https://doi.org/10.3390/jof8020188

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