Detection of circulating galactomannan in serum samples for diagnosis of Penicillium marneffei infection and cryptococcosis among patients infected with human immunodeficiency virus
Journal
Journal of Clinical Microbiology
Journal Volume
45
Journal Issue
9
Pages
2858-2862
Date Issued
2007
Author(s)
Abstract
Galactomannan (GM) is a heteropolysaccharide in the cell walls of most Aspergillus and Penicillium species. Cross-reactivity of Cryptococcus neoformans galactoxylomannan in an Aspergillus GM test has also been reported. In this study, we used a Platelia Aspergillus enzyme immunoassay kit (Bio-Rad) to test serum samples obtained from 48 human immunodeficiency virus (HIV)-infected patients (15 with penicilliosis [7 with fungemia alone, 4 with cavitary lung lesions alone, 3 with both fungemia and cavitary lung lesions, and 1 with disseminated disease], 22 with cryptococcosis [11 with fungemia alone, 5 with cavitary lung lesions, 3 with both, and 3 with meningitis alone], and 11 without any invasive fungal infection [control]) for GM levels. None of the patients had aspergillosis or concurrent use of piperacillin-tazobactam or amoxicillin-clavulanate. The median time between diagnosis of fungal infection and collection of serum samples was 0 days for penicilliosis and 1.5 days for cryptococcosis. Of patients with penicilliosis, cryptococcosis, and controls, 73.3%, 13.6%, and 9%, respectively, had GM optical density (OD) indices of >0.5 (P = 0.0001). GM OD indices were higher for penicilliosis (median OD index, 4.419; range, 0.158 to >20) than for cryptococcosis (median, 0.247; range, 0.112 to 3.849) cases (P < 0.001). Patients with fungemic penicilliosis had higher OD indices (median, 10.628; range, 0.401 to >20) than patients with nonfungemic penicilliosis (median, 0.378; range, 0.158 to 4.419) and patients with cryptococcemia (median, 0.231; range, 0.112 to 1.168) (P < 0.001). Of the 15 patients with cavitary lung lesions, those with penicilliosis had higher antigen levels (median OD index, 1.641; range, 0.247 to >20) than those with cryptococcosis (median, 0.227; range, 0.112 to 3.849) (P = 0.011). This study showed that the GM OD index was significantly elevated for HIV patients with penicilliosis. The use of the GM antigen assay may facilitate earlier diagnosis of Penicillium marneffei infection for HIV-infected patients in areas of endemicity. Copyright ? 2007, American Society for Microbiology. All Rights Reserved.
SDGs
Other Subjects
amoxicillin plus clavulanic acid; galactomannan; piperacillin plus tazobactam; adult; aged; article; aspergillosis; Aspergillus; clinical article; controlled study; cross reaction; cryptococcosis; early diagnosis; endemic disease; female; fungemia; human; Human immunodeficiency virus infected patient; lung cavitation; male; meningitis; mycosis; Penicillium marneffei; priority journal; Adult; Aged; Aged, 80 and over; Cryptococcosis; Cryptococcus; Female; Fungemia; HIV Infections; Humans; Lung Diseases, Fungal; Male; Mannans; Middle Aged; Mycoses; Penicillium; Serum; Aspergillus; Filobasidiella neoformans; Human immunodeficiency virus; Penicillium; Penicillium marneffei
Type
journal article