Table 2.
Group | Patient | Final classificationb | No. of specimens positive by assay 1c | No. of specimens positive by the GM ELISAd | Risk factor(s)e | Clinical sign(s)f | AM at first classification or prophylaxisg |
---|---|---|---|---|---|---|---|
Possible/probable-IA patients detected by assay 1 | M030 | Probable | 5h | 1 | a, t | d | P |
V064 | Probable | 4h | 2 | n | d, h | P | |
M028 | Possible | 1 | None | a, t | d | P | |
M035 | Possible | 3h (A. fumigatus, A. flavus, A. terreus) | None | a, n | d, h, c | V | |
M036 | Possible | 1 | None | a, n, t | d, h | V | |
M037 | Possible | 2 | None | n | d, h | V | |
M039 | Possible | 1 | None | a, co, n, t | d, ac | ||
T095 | Possible | 1i | 1 | a, t | Nonej | P | |
V060 | Possible | 2 | None | n | d | ||
V062 | Possible | 2 | None | n | d | P | |
V063 | Possible | 1 | None | n | d, h | V | |
V069 | Possible | 1 (A. flavus) | None | n | d | ||
Possible/probable-IA patients not detected by assay 1 | M033 | Probable | 0 | 1 | a | d | E |
M029 | Possible | 0 | None | a, n, t | d, h | P | |
M038 | Possible | 0 | None | a, n, t | d, h | ||
M040 | Possible | 0 | None | n | d | V | |
T090 | Possible | 0 | None | n | d, h | ||
T098 | Possible | 0 | None | a, t | d | P | |
T099 | Possible | 0 | None | n, a, t | d | ||
V049 | Possible | 0 | None | n, a | d, h, c | V | |
V065 | Possible | 0 | None | a, t | d | P | |
V070 | Possible | 0 | None | n | d | V | |
Unclassified patients detected by assay 1 | T094 | Not classified | 1 | None | a, t | None, AMk | |
V058 | Not classified | 1 | None | a, n, t | None | ||
V067 | Not classified | 1 | None | n | None | ||
M032 | Not classified | 1 | None | a, t | None | ||
M021 | Not classified | 1 | None | Nonel | None | ||
V042 | Not classified | 1 | None | n | None, AMk | ||
Unclassified patients detected by galactomannan ELISA | T091 | Not classified | 0 | 1 | a, t | None |
All patients that had either clinical signs of invasive aspergillosis (possible, probable, or proven IA according to EORTC/MSG criteria) or positive diagnostic results.
The final classification of the patient according to EORTC/MSG criteria as having proven, probable, or possible invasive aspergillosis.
Species detected are given in parentheses if they are not A. fumigatus.
A positive GM ELISA result is a microbiological criterion for IA per EORTC/MSG criteria.
Risk factors for invasive aspergillosis according to EORTC/MSG criteria: a, allogeneic stem cell transplantation; co, corticosteroid treatment; n, neutropenia; t, T-cell-suppressive therapy.
Clinical signs for invasive aspergillosis according to EORTC/MSG criteria (all referring to chest CT scans): ac, positive air crescent sign; c, cavitation; d, dense well circumscribed lesions; h, positive halo sign.
AM, antimycotic therapy was initiated at the time the patient was first classified as possibly or probably having IFI. V, voriconazole; P, posaconazole; E, echinocandin. All patients received fluconazole and/or topical polyene prophylaxis. Unclassified patients received antifungal prophylaxis at the time of the positive assay 1/galactomannan ELISA result.
These patients had consecutive positive assay 1 results.
Patient T095 also had one positive assay 2 result.
For patient T095, only nonspecific infiltrates were detected in a chest CT scan. Due to the multiplicity of positive biomarkers, we grouped this patient with the patients who possibly had IA despite T095's not formally fulfilling the EORTC/MSG criteria.
AM, antimycotic treatment with anti-Aspergillus efficacy was initiated in patients T094 (echinocandin) and V042 (voriconazole).
This patient was included due to an expected duration of neutropenia of >10 days; however, neutropenia then turned out to be <10 days.