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Comparison of galactomannan lateral flow assay and enzyme immunoassay to identify Aspergillus spp. in bronchoalveolar lavage fluid

Summary

Researchers compared two rapid tests for detecting a fungal infection called aspergillosis in lung fluid samples. One test uses a simple lateral flow format (like a COVID test), while the other is a more traditional enzyme immunoassay. Both tests had good agreement, with the lateral flow assay showing high accuracy and the advantage of being faster and requiring fewer laboratory resources, making it especially useful for hospitals with limited equipment.

Background

Aspergillus species can colonize and infect both immunocompetent and immunocompromised hosts. Conventional fungal identification depends on microscopic analysis and culture growth. Non-growth dependent diagnostic methods such as galactomannan detection offer faster alternatives for diagnosing invasive fungal infections.

Objective

This study aimed to compare galactomannan detection using Lateral Flow Assay (LFA) and Enzyme Immunoassay (EIA) methods in bronchoalveolar lavage fluid (BALF) samples from patients with suspected invasive pulmonary aspergillosis.

Results

GM-LFA was positive in 12/71 (16.9%) samples compared to 9/71 (12.6%) for GM-EIA, a non-significant difference (p=0.36). Eight samples (11.3%) showed divergent results between the two methods. GM-LFA demonstrated sensitivity of 73.3%, specificity of 92.35%, positive predictive value of 62.85%, and negative predictive value of 95.15% when using GM-EIA as the standard.

Conclusion

The Aspergillus galactomannan LFA with reader demonstrated good agreement with GM-EIA and can serve as a resourceful tool for invasive aspergillosis diagnosis in BALF samples. The rapid turnaround time and cost-benefit make it a promising alternative, particularly for settings with limited laboratory resources.
  • Published in:Brazilian Journal of Infectious Diseases,
  • Study Type:Retrospective Comparative Analysis,
  • Source: PMID: 39009082, doi: 10.1016/j.bjid.2024.103838
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