Skip to main content
PMC home page
Journal of Clinical Microbiology logoLink to Journal of Clinical Microbiology
. 1995 Dec;33(12):3150–3153. doi: 10.1128/jcm.33.12.3150-3153.1995

Comparison of antigen detection and PCR assay using bronchoalveolar lavage fluid for diagnosing invasive pulmonary aspergillosis in patients receiving treatment for hematological malignancies.

P E Verweij 1, J P Latgé 1, A J Rijs 1, W J Melchers 1, B E De Pauw 1, J A Hoogkamp-Korstanje 1, J F Meis 1
PMCID: PMC228662  PMID: 8586691

Abstract

The performance of a sandwich enzyme-linked immunosorbent assay (ELISA) which detects Aspergillus galactomannan (GM) was evaluated in bronchoalveolar lavage (BAL) fluid samples from 19 patients who were treated for hematological malignancies and who were suspected of having invasive pulmonary aspergillosis (IPA). All patients had fever and pulmonary infiltrates on the chest roentgenogram on the day that the BAL fluid was obtained. The ELISA results were compared with the results of culture and Aspergillus genus-specific PCR analysis of BAL fluid samples. ELISA was also performed with serum samples. Aspergillus species were detected by PCR or ELISA with BAL fluid samples from five of seven patients who had radiological evidence of IPA. Serum ELISA results were positive for all patients with ELISA-positive BAL fluid, and for four patients the serum ELISA was positive before the BAL fluid was obtained. PCR and ELISA were positive for 2 and 1 of 10 BAL fluid samples, respectively, obtained from patients without radiological evidence of IPA, and 5 and 2 of 35 BAL fluid samples, respectively, obtained from nonneutropenic patients. This preliminary investigation suggests that GM may be detected by ELISA in BAL fluid samples from patients at risk of IPA, but that monitoring of serum GM levels may allow for the earlier diagnosis of IPA. However, further evaluation in prospective studies is required.

Full Text

The Full Text of this article is available as a PDF (169.5 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Aisner J., Wiernik P. H., Schimpff S. C. Treatment of invasive aspergillosis: relation of early diagnosis and treatment to response. Ann Intern Med. 1977 May;86(5):539–543. doi: 10.7326/0003-4819-86-5-539. [DOI] [PubMed] [Google Scholar]
  2. Andrews C. P., Weiner M. H. Aspergillus antigen detection in bronchoalveolar lavage fluid from patients with invasive aspergillosis and aspergillomas. Am J Med. 1982 Sep;73(3):372–380. [PubMed] [Google Scholar]
  3. Andrews C. P., Weiner M. H. Immunodiagnosis of invasive pulmonary aspergillosis in rabbits. Fungal antigen detected by radioimmunoassay in bronchoalveolar lavage fluid. Am Rev Respir Dis. 1981 Jul;124(1):60–64. doi: 10.1164/arrd.1981.124.1.60. [DOI] [PubMed] [Google Scholar]
  4. Ansorg R., Heintschel von Heinegg E., Rath P. M. Aspergillus antigenuria compared to antigenemia in bone marrow transplant recipients. Eur J Clin Microbiol Infect Dis. 1994 Jul;13(7):582–589. doi: 10.1007/BF01971310. [DOI] [PubMed] [Google Scholar]
  5. Bodey G., Bueltmann B., Duguid W., Gibbs D., Hanak H., Hotchi M., Mall G., Martino P., Meunier F., Milliken S. Fungal infections in cancer patients: an international autopsy survey. Eur J Clin Microbiol Infect Dis. 1992 Feb;11(2):99–109. doi: 10.1007/BF01967060. [DOI] [PubMed] [Google Scholar]
  6. Bretagne S., Costa J. M., Marmorat-Khuong A., Poron F., Cordonnier C., Vidaud M., Fleury-Feith J. Detection of Aspergillus species DNA in bronchoalveolar lavage samples by competitive PCR. J Clin Microbiol. 1995 May;33(5):1164–1168. doi: 10.1128/jcm.33.5.1164-1168.1995. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Francis P., Lee J. W., Hoffman A., Peter J., Francesconi A., Bacher J., Shelhamer J., Pizzo P. A., Walsh T. J. Efficacy of unilamellar liposomal amphotericin B in treatment of pulmonary aspergillosis in persistently granulocytopenic rabbits: the potential role of bronchoalveolar D-mannitol and serum galactomannan as markers of infection. J Infect Dis. 1994 Feb;169(2):356–368. doi: 10.1093/infdis/169.2.356. [DOI] [PubMed] [Google Scholar]
  8. Haynes K., Rogers T. R. Retrospective evaluation of a latex agglutination test for diagnosis of invasive aspergillosis in immunocompromised patients. Eur J Clin Microbiol Infect Dis. 1994 Aug;13(8):670–674. doi: 10.1007/BF01973998. [DOI] [PubMed] [Google Scholar]
  9. Hopwood V., Johnson E. M., Cornish J. M., Foot A. B., Evans E. G., Warnock D. W. Use of the Pastorex aspergillus antigen latex agglutination test for the diagnosis of invasive aspergillosis. J Clin Pathol. 1995 Mar;48(3):210–213. doi: 10.1136/jcp.48.3.210. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Kuhlman J. E., Fishman E. K., Burch P. A., Karp J. E., Zerhouni E. A., Siegelman S. S. Invasive pulmonary aspergillosis in acute leukemia. The contribution of CT to early diagnosis and aggressive management. Chest. 1987 Jul;92(1):95–99. doi: 10.1378/chest.92.1.95. [DOI] [PubMed] [Google Scholar]
  11. Kuhlman J. E., Fishman E. K., Siegelman S. S. Invasive pulmonary aspergillosis in acute leukemia: characteristic findings on CT, the CT halo sign, and the role of CT in early diagnosis. Radiology. 1985 Dec;157(3):611–614. doi: 10.1148/radiology.157.3.3864189. [DOI] [PubMed] [Google Scholar]
  12. Kurup V. P., Kumar A. Immunodiagnosis of aspergillosis. Clin Microbiol Rev. 1991 Oct;4(4):439–456. doi: 10.1128/cmr.4.4.439. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Latgé J. P., Kobayashi H., Debeaupuis J. P., Diaquin M., Sarfati J., Wieruszeski J. M., Parra E., Bouchara J. P., Fournet B. Chemical and immunological characterization of the extracellular galactomannan of Aspergillus fumigatus. Infect Immun. 1994 Dec;62(12):5424–5433. doi: 10.1128/iai.62.12.5424-5433.1994. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Lortholary O., Meyohas M. C., Dupont B., Cadranel J., Salmon-Ceron D., Peyramond D., Simonin D. Invasive aspergillosis in patients with acquired immunodeficiency syndrome: report of 33 cases. French Cooperative Study Group on Aspergillosis in AIDS. Am J Med. 1993 Aug;95(2):177–187. doi: 10.1016/0002-9343(93)90258-q. [DOI] [PubMed] [Google Scholar]
  15. Maile C. W., Moore A. V., Ulreich S., Putman C. E. Chest radiographic-pathologic correlation in adult leukemia patients. Invest Radiol. 1983 Nov-Dec;18(6):495–499. doi: 10.1097/00004424-198311000-00002. [DOI] [PubMed] [Google Scholar]
  16. Melchers W. J., Verweij P. E., van den Hurk P., van Belkum A., De Pauw B. E., Hoogkamp-Korstanje J. A., Meis J. F. General primer-mediated PCR for detection of Aspergillus species. J Clin Microbiol. 1994 Jul;32(7):1710–1717. doi: 10.1128/jcm.32.7.1710-1717.1994. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Pasmans H. L., Loosveld O. J., Schouten H. C., Thunnissen F., van Engelshoven J. M. Invasive aspergillosis in immunocompromised patients: findings on plain film and (HR)CT. Eur J Radiol. 1992 Jan-Feb;14(1):37–40. doi: 10.1016/0720-048x(92)90059-i. [DOI] [PubMed] [Google Scholar]
  18. Reddy L. V., Kumar A., Kurup V. P. Specific amplification of Aspergillus fumigatus DNA by polymerase chain reaction. Mol Cell Probes. 1993 Apr;7(2):121–126. doi: 10.1006/mcpr.1993.1016. [DOI] [PubMed] [Google Scholar]
  19. Rogers T. R., Haynes K. A., Barnes R. A. Value of antigen detection in predicting invasive pulmonary aspergillosis. Lancet. 1990 Nov 17;336(8725):1210–1213. doi: 10.1016/0140-6736(90)92831-2. [DOI] [PubMed] [Google Scholar]
  20. Sabetta J. R., Miniter P., Andriole V. T. The diagnosis of invasive aspergillosis by an enzyme-linked immunosorbent assay for circulating antigen. J Infect Dis. 1985 Nov;152(5):946–953. doi: 10.1093/infdis/152.5.946. [DOI] [PubMed] [Google Scholar]
  21. Stynen D., Goris A., Sarfati J., Latgé J. P. A new sensitive sandwich enzyme-linked immunosorbent assay to detect galactofuran in patients with invasive aspergillosis. J Clin Microbiol. 1995 Feb;33(2):497–500. doi: 10.1128/jcm.33.2.497-500.1995. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Tang C. M., Holden D. W., Aufauvre-Brown A., Cohen J. The detection of Aspergillus spp. by the polymerase chain reaction and its evaluation in bronchoalveolar lavage fluid. Am Rev Respir Dis. 1993 Nov;148(5):1313–1317. doi: 10.1164/ajrccm/148.5.1313. [DOI] [PubMed] [Google Scholar]
  23. Tjhie J. H., van Kuppeveld F. J., Roosendaal R., Melchers W. J., Gordijn R., MacLaren D. M., Walboomers J. M., Meijer C. J., van den Brule A. J. Direct PCR enables detection of Mycoplasma pneumoniae in patients with respiratory tract infections. J Clin Microbiol. 1994 Jan;32(1):11–16. doi: 10.1128/jcm.32.1.11-16.1994. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Verweij P. E., Rijs A. J., De Pauw B. E., Horrevorts A. M., Hoogkamp-Korstanje J. A., Meis J. F. Clinical evaluation and reproducibility of the Pastorex Aspergillus antigen latex agglutination test for diagnosing invasive aspergillosis. J Clin Pathol. 1995 May;48(5):474–476. doi: 10.1136/jcp.48.5.474. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Verweij P. E., Stynen D., Rijs A. J., de Pauw B. E., Hoogkamp-Korstanje J. A., Meis J. F. Sandwich enzyme-linked immunosorbent assay compared with Pastorex latex agglutination test for diagnosing invasive aspergillosis in immunocompromised patients. J Clin Microbiol. 1995 Jul;33(7):1912–1914. doi: 10.1128/jcm.33.7.1912-1914.1995. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Walsh T. J., Garrett K., Feurerstein E., Girton M., Allende M., Bacher J., Francesconi A., Schaufele R., Pizzo P. A. Therapeutic monitoring of experimental invasive pulmonary aspergillosis by ultrafast computerized tomography, a novel, noninvasive method for measuring responses to antifungal therapy. Antimicrob Agents Chemother. 1995 May;39(5):1065–1069. doi: 10.1128/aac.39.5.1065. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Warnock D. W., Foot A. B., Johnson E. M., Mitchell S. B., Cornish J. M., Oakhill A. Aspergillus antigen latex test for diagnosis of invasive aspergillosis. Lancet. 1991 Oct 19;338(8773):1023–1024. doi: 10.1016/0140-6736(91)91890-7. [DOI] [PubMed] [Google Scholar]
  28. Weiner M. H., Talbot G. H., Gerson S. L., Fetchick R., Andrews C., Peacock J. E., Filice G., Cohen M., Provencher M., Cassileth P. Detection of fungal antigen in body fluids for diagnosis of invasive aspergillosis. Zentralbl Bakteriol Mikrobiol Hyg A. 1986 Jul;261(4):517–522. doi: 10.1016/s0176-6724(86)80085-2. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Clinical Microbiology are provided here courtesy of American Society for Microbiology (ASM)

RESOURCES