Advertisement

Serological Approaches

  • Barbora WeinbergerovaEmail author
  • Iva Kocmanova
  • Zdenek Racil
  • Jiri Mayer
Protocol
Part of the Methods in Molecular Biology book series (MIMB, volume 1508)

Abstract

The diagnosis of invasive fungal diseases (IFD) based on clinical, radiological, and conventional microbiological findings is not reliable and is often delayed. Non-culture-based methods with higher sensitivity and specificity may reduce diagnostic time and result in decreased IFD morbidity and mortality. These methods are now increasingly used to manage patients at risk of IFD. Among available biomarkers, fungal antigens have been investigated as an aid to early diagnosis and are predominantly used as screening tests to prompt antifungal treatment mainly in patients with hematological malignancies. The revised version of the European Organization for Research and Treatment of Cancer/Mycoses Study Group (EORTC/MSG) consensus definitions includes some of these biological markers (galactomannan, 1,3-beta-d-glucan, cryptococcus antigen).

Key words

Galactomannan The Platelia Aspergillus enzyme immunoassay Latex agglutination Aspergillus lateral-flow device 1,3-beta-d-glucan Fungitell assay 

References

  1. 1.
    Fontaine T, Simenel C, Dubreucqetal G et al (2000) Molecular organization of the alkali-insoluble fraction of Aspergillus fumigatus cell wall. J Biol Chem 275:27594–27607Google Scholar
  2. 2.
    Stynen D, Sarfati J, Gorisetal A et al (1992) Rat monoclonal antibodies against Aspergillus galactomannan. Infect Immun 60:2237–2245Google Scholar
  3. 3.
    Mennink-Kersten MASH, Donnelly JP, Verweij PE (2004) Detection of circulating galactomannan for the diagnosis and management of invasive aspergillosis. Lancet Infect Dis 4:349–357CrossRefPubMedGoogle Scholar
  4. 4.
    Hope WW, Kruhlak MJ, Lymanetal CA et al (2007) Pathogenesis of Aspergillus fumigatus and the kinetics of galactomannan in an in vitro model of early invasive pulmonary aspergillosis: implications for antifungal therapy. J Infect Dis 195:455–466Google Scholar
  5. 5.
    Franquet T, Müller NL, Giménez A et al (2001) Spectrum of pulmonary aspergillosis: histologic, clinical, and radiologic findings. Radiographics 21:825–837CrossRefPubMedGoogle Scholar
  6. 6.
    Verweij PE, Weemaes CM, Curfs JHAJ et al (2000) Failure to detect circulating Aspergillus markers in a patient with chronic granulomatous disease and invasive aspergillosis. J Clin Microbiol 38:3900–3901Google Scholar
  7. 7.
    Van Cutsem J, Meulemans L, Van Gerven F et al (1990) Detection of circulating galactomannan by Pastorex Aspergillus in experimental invasive aspergillosis. Mycoses 33:61–69Google Scholar
  8. 8.
    Thornton CR (2008) Development of an immunochromatographic lateral-flow device for rapid serodiagnosis of invasive aspergillosis. Clin Vaccine Immunol 15:1095–1105CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Thornton C, Johnson G, Agrawal S (2012) Detection of invasive pulmonary aspergillosis in haematological malignancy patients by using lateral-flow technology. J Vis Exp 61:3721Google Scholar
  10. 10.
    Pan Z, Zhang J, Zhou H et al (2015) Diagnostic accuracy of a novel lateral-flow device in invasive aspergillosis: a meta-analysis. J Med Microbiol 64:702–707CrossRefPubMedGoogle Scholar
  11. 11.
    Cordonnier C, Pautas C, Maury S et al (2009) Empirical versus preemptive antifungal therapy for high-risk, febrile, neutropenic patients: a randomized, controlled trial. Clin Infect Dis 48:1042–1051CrossRefPubMedGoogle Scholar
  12. 12.
    Maertens J, Theunissen K, Verhoef G et al (2005) Galactomannan and computed tomography-based preemptive antifungal therapy in neutropenic patients at high risk for invasive fungal infection: a prospective feasibility study. Clin Infect Dis 41:1242–1250CrossRefPubMedGoogle Scholar
  13. 13.
    Marchetti O, Lamoth F, Mikulska M et al (2012) ECIL recommendations for the use of biological markers for the diagnosis of invasive fungal diseases in leukemic patients and hematopoietic SCT recipients. European Conference on Infections in Leukemia (ECIL) Laboratory Working Groups. Bone Marrow Transplant 47:846–854CrossRefPubMedGoogle Scholar
  14. 14.
    Meersseman W, Lagrou K, Maertens J et al (2008) Galactomannan in bronchoalveolar lavage fluid: a tool for diagnosing aspergillosis in intensive care unit patients. Am J Respir Crit Care Med 177:27–34CrossRefPubMedGoogle Scholar
  15. 15.
    Maertens J, Maertens V, Theunissen K et al (2009) Bronchoalveolar lavage fluid galactomannan for the diagnosis of invasive pulmonary aspergillosis in patients with hematologic diseases. Clin Infect Dis 49:1688–1693CrossRefPubMedGoogle Scholar
  16. 16.
    Heng SC, Morrissey O, Chen SC et al (2015) Utility of bronchoalveolar lavage fluid galactomannan alone or in combination with PCR for the diagnosis of invasive aspergillosis in adult hematology patients: a systematic review and meta-analysis. Crit Rev Microbiol 41:124–134CrossRefPubMedGoogle Scholar
  17. 17.
    Arvanitis M, Anagnostou T, Mylonakis E (2015) Galactomannan and polymerase chain reaction–based screening for invasive aspergillosis among high-risk hematology patients: a diagnostic meta-analysis. Clin Infect Dis 61:1263–1272CrossRefPubMedGoogle Scholar
  18. 18.
    Pfeiffer CD, Fine JP, Safdar N et al (2006) Diagnosis of invasive aspergillosis using a galactomannan assay: a meta-analysis. Clin Infect Dis 42:1417–1427CrossRefPubMedGoogle Scholar
  19. 19.
    Ascioglu S, Rex JH, de Pauw B et al (2002) Defining opportunistic invasive fungal infections in immunocompromised patients with cancer and hematopoietic stem cell transplants: an international consensus. Clin Infect Dis 34:7–14CrossRefPubMedGoogle Scholar
  20. 20.
    De Pauw B, Walsh TJ, Donnelly JP et al (2008) Revised definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) Consensus Group. Clin Infect Dis 46:1813–1821CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    D’Haese J, Theunissen K, Vermeulen E et al (2012) Detection of galactomannan in bronchoalveolar lavage fluid samples of patients at risk for invasive pulmonary aspergillosis: analytical and clinical validity. J Clin Microbiol 50:1258–1263CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Guo YL, Chen YQ, Wang K et al (2010) Accuracy of BAL galactomannan in diagnosing invasive aspergillosis: a bivariate metaanalysis and systematic review. Chest 138:817–824CrossRefPubMedGoogle Scholar
  23. 23.
    Marr KA, Balajee SA, McLaughlin L et al (2004) Detection of galactomannan antigenemia by enzyme immunoassay for the diagnosis of invasive aspergillosis: variables that affect performance. J Infect Dis 190:641–649CrossRefPubMedGoogle Scholar
  24. 24.
    Becker MJ, de Marie S, Willemse D et al (2000) Quantitative galactomannan detection is superior to PCR in diagnosing and monitoring invasive pulmonary aspergillosis in an experimental rat model. J Clin Microbiol 38:1434–1438PubMedPubMedCentralGoogle Scholar
  25. 25.
    Marr KA, Laverdiere M, Gugel A et al (2005) Antifungal therapy decreases sensitivity of the Aspergillus galactomannan enzyme immunoassay. Clin Infect Dis 40:1762–1769Google Scholar
  26. 26.
    Cordonnier C, Botterel F, Ben Amor R et al (2009) Correlation between galactomannan antigen levels in serum and neutrophil counts in haematological patients with invasive aspergillosis. Clin Microbiol Infect 15:81–86CrossRefPubMedGoogle Scholar
  27. 27.
    Vallor AC, Kirkpatrick WR, Najvar LK et al (2008) Assessment of Aspergillus fumigatus burden in pulmonary tissue of guinea pigs by quantitative PCR, galactomannan enzyme immunoassay, and quantitative culture. Antimicrob Agents Chemother 52:2593–2598Google Scholar
  28. 28.
    Racil Z, Kocmanova I, Toskova M et al (2011) Galactomannan detection in bronchoalveolar lavage fluid for the diagnosis of invasive aspergillosis in patients with hematological diseases-the role of factors affecting assay performance. Int J Infect Dis 15:e874–e881CrossRefPubMedGoogle Scholar
  29. 29.
    Viscoli, C., Machetti, M., Cappellano, P. et al. False positive galactomannan Platelia Aspergillus test results for patients receiving piperacillin–tazobactam. Clin Infect Dis 38, 913–916.Google Scholar
  30. 30.
    Racil, Z., Kocmanova, I., Lengerova, M. et al. Intravenous PLASMALYTE as a major cause of false-positive results of Platelia Aspergillus test for galactomannan detection in serum. J Clin Microbiol 45, 3141–3142.Google Scholar
  31. 31.
    Mennink-Kersten MASH, Ruegebrink D, Klont RR et al (2008) Improved detection of circulating Aspergillus antigen by use of a modified pretreatment procedure. J Clin Microbiol 46:1391–1397Google Scholar
  32. 32.
    Oren I, Avidor I, Sprecher H (2012) Lack of intra-laboratory reproducibility in using Platelia Aspergillus enzyme immunoassay test for detection of Aspergillus galactomannan antigen. Transpl Infect Dis 14:107–109Google Scholar
  33. 33.
    Platelia™ Aspergillus EIA, laboratory manual, Bio-Rad.Google Scholar
  34. 34.
    Obayashi T, Yoshida M, Tamura H et al (1992) Determination of plasma (1/3)-b-D-glucan: a new diagnostic aid to deep mycosis. J Med Vet Mycol 30:275–280CrossRefPubMedGoogle Scholar
  35. 35.
    Lamoth F, Cruciani M, Mengoli C et al (2012) β-Glucan antigenemia assay for the diagnosis of invasive fungal infections in patients with hematological malignancies: a systematic review and meta-analysis of cohort studies from the Third European Conference on Infections in Leukemia (ECIL-3). Third European Conference on Infections in Leukemia (ECIL-3). Clin Infect Dis 54:633–643CrossRefPubMedGoogle Scholar
  36. 36.
    Hou TY, Wang SH, Liang SX et al (2015) The screening performance of serum 1,3-beta-D-glucan in patients with invasive fungal diseases: a meta-analysis of prospective cohort studies. PLoS One 10, e0131602. doi: 10.1371/journal.pone.0131602 CrossRefPubMedPubMedCentralGoogle Scholar
  37. 37.
    Onishi A, Sugiyama D, Kogata Y et al (2012) Diagnostic accuracy of serum 1,3-β-D-glucan for pneumocystis jiroveci pneumonia, invasive candidiasis, and invasive aspergillosis: systematic review and meta-analysis. J Clin Microbiol 50:7–15CrossRefPubMedPubMedCentralGoogle Scholar
  38. 38.
    Rose SR, Vallabhajosyula S, Velez MG et al (2014) The utility of bronchoalveolar lavage beta-D-glucan testing for the diagnosis of invasive fungal infections. J Infect 69:278–283CrossRefPubMedPubMedCentralGoogle Scholar
  39. 39.
    Mutschlechner W, Risslegger B, Willinger B et al (2015) Bronchoalveolar lavage fluid (1,3)β-D-glucan for the diagnosis of invasive fungal infections in solid organ transplantation: a prospective multicenter study. Transplantation. doi:  10.1097/TP.0000000000000635
  40. 40.
    Fungitell™, laboratory manual, Associates of Cape Cod International. http://www.acciusa.com/pdfs/accProduct/Fungitell_multilang_pisheets/Fungitell%20Insert%20EN.pdf

Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Barbora Weinbergerova
    • 1
    Email author
  • Iva Kocmanova
    • 1
    • 2
  • Zdenek Racil
    • 1
    • 3
  • Jiri Mayer
    • 1
    • 3
  1. 1.Department of Internal Medicine—Hematology and OncologyMasaryk University and University Hospital BrnoBrnoCzech Republic
  2. 2.Department of MicrobiologyUniversity Hospital BrnoBrnoCzech Republic
  3. 3.CEITEC—Central European Institute of TechnologyMasaryk UniversityBrnoCzech Republic

Personalised recommendations