Table 3.
Performance of diagnostic tests in serum samples (IL-8, IL-6, LFD, Aspergillus PCR, and BDG) and in same-day BALF samples (IL-8, LFD, Aspergillus PCR), as well as combinations, for differentiating probable invasive aspergillosis (IA; n=11) versus no evidence for IA (n=63) ordered by Diagnostic Odds Ratios (DOR). In the right columns: sensitivities for possible IA/possible IMI and possible IA/probable IMI.
| Test/test combination | Sensitivity | Specificity | PPV | NPV | DOR | Positivity in Possible IA / possible IMI cases | Positivity in possible IA / probable IMI cases |
|---|---|---|---|---|---|---|---|
| Serum IL-8 (>300 pg/mL) | 45% (5/11) | 98% (62/63) | 83% (5/6) | 91% (62/68) | 51.7 (5.1–518) | 8% (2/25) | 0% (0/7) |
| Serum IL-8 (>60 pg/mL) | 55% (6/11) | 92% (58/63) | 55% (6/11) | 92% (58/63) | 13.9 (3.1–62.2) | 16% (4/25) | 43% (3/7) |
| Serum IL-8 (>14 pg/mL) | 82% (9/11) | 63% (40/63) | 28% (9/32) | 95% (40/42) | 7.8 (1.6–39.4) | 48% (12/25) | 57% (4/7) |
| Serum IL-6 (>40 pg/mL) | 73% (8/11) | 70% (44/63) | 30% (8/27) | 94% (44/47) | 6.2 (1.5–25.9) | 20% (5/25) | 29% (2/7) |
| Serum LFD (45 min) | 9% (1/11) | 97% (61/63) | 33% (1/3) | 86% (61/71) | 3.0 (0.3–36.9) | 16% (4/25) | 0 |
| Serum BDG (>80 pg/mL) | 45% (5/11) | 75% (47/63) | 24% (5/21) | 89% (47/53) | 2.4 (0.7–9.1) | 4% (1/25)# | 86% (6/7) |
| Blood Aspergillus PCR | 0% (0/10) | 100% (55/55) | – | 85% (55/65) | – | 0 | 0 |
| Serum LFD (15 min) | 0% (0/10) | 98% (54/55) | – | 84% (54/64) | – | 4% (1/25) | 0 |
| BALF LFD (10 min) | 73% (8/11) | 95% (60/63) | 73% (8/11) | 95% (60/63) | 53.3 (9.2–310) | 0 | 0 |
| BALF Aspergillus PCR | 27% (3/11) | 98% (58/59) | 75% (3/4) | 91% (58/64) | 21.8 (2.0–235) | 4% (1/24) | 0 |
| BALF LFD (15 min) | 73% (8/11) | 87% (55/63) | 50% (8/16) | 95% (55/58) | 18.3 (4.0–83.8) | 12% (3/25) | 43% (3/7) |
| BALF IL-8 (>556 pg/mL) | 91% (10/11) | 48% (30/63) | 23% (10/43) | 97% (30/31) | 9.1 (1.1–75.3) | 52% (13/25) | 71% (5/7) |
| BALF IL-8 (>1000 pg/mL) | 73% (8/11) | 67% (42/63) | 28% (8/29) | 93% (42/45) | 5.3 (1.3–22.2) | 36% (9/25) | 43% (3/7) |
| Serum IL-8 (>300 pg/mL) AND/OR Serum IL-6 (>40 pg/mL) | 73% (8/11) | 70% (44/63) | 30% (8/27) | 94% (44/47) | 6.2 (1.5–25.9) | 20% (5/25) | 29% (2/7) |
| Serum IL-8 (>300 pg/mL) AND/OR BALF LFD (10 min) | 100% (11/11) | 94% (59/63) | 73% (11/15) | 100% (59/59) | 304 (15.3–6042) | 8% (2/25) | 0% (0/7) |
| Serum IL-8 (>300 pg/mL) AND/OR BALF LFD (15 min) | 100% (11/11) | 86% (54/63) | 55% (11/20) | 100% (54/54) | 132 (7.2–2432) | 20% (5/25) | 43% (3/7) |
| Serum IL-8 (>300 pg/mL) AND/OR BALF Aspergillus PCR | 91% (10/11) | 97% (57/59) | 83% (10/12) | 98% (57/58) | 285 (23.6–3447) | 12% (3/25) | 0 |
BDG positive in a case with probable IA and Pneumocystis infection and therefore excluded as mycological criterion for probable IMI in that case
Abbreviations: BALF= bronchoalveolar lavage fluid; BDG=beta-D-glucan; IL=Interleukin; IMI=Invasive Mold Infection; LFD=Aspergillus specific Lateral-flow-device Test; NPV=negative predictive value; PPV=positive predictive value;