The Diagnosis of Invasive and Noninvasive XXXX by Serum and Bronchoalveolar Lavage Fluid Galactomannan Assay.

@entity1 @entity57 @entity3124 @entity2381 @entity1030
UNASSIGNED: The incidence and mortality of invasive @entity57 (IPA) are rising, particularly in @entity3124 @entity1 and @entity1 with severe @entity1030 ( @entity1030 ). Noninvasive @entity2381 occurring in these @entity1 requires special attention because of the possibility of developing subsequent IPA, given the poor health and worsened immune state of these @entity1 . We compared the performance of the Platelia galactomannan (GM) enzyme immunoassay in the bronchoalveolar lavage fluid (BALF) and serum. The sensitivity, and specificity of BALF-GM were 85.4% and 62.4%, and those of serum-GM were 67.9% and 93.5% at the cutoff index of 0.5. As the cutoff index increased, the specificity of BALF-GM detection was increased with the detriment of sensitivity. The area under the ROC curves was 0.817 (95% CI: 0.718-0.916) for BALF-GM and 0.819 (95% CI: 0.712-0.926) for serum-GM. The optimal cutoff index was 1.19 for BALF-GM, and the sensitivity and specificity were 67.9% and 89.2%. The BALF-GM assay is more sensitive in detecting @entity57 than serum-GM assay and fungal cultures. However, BALF-GM assay has a high false-positive rate at the cutoff index of 0.5. Hence, the diagnostic cutoff index of the BALF-GM assay should be improved to avoid the overdiagnosis of @entity57 in clinic.
