JCM Accepted Manuscript Posted Online 9 December 2015 J. Clin. Microbiol. doi:10.1128/JCM.02913-15 Copyright © 2015, American Society for Microbiology. All Rights Reserved.
1
Diagnostic performance of galactomannan antigen testing in cerebrospinal fluid
2 3
G.M. Chong1#, J.A. Maertens2, K. Lagrou3, G.J. Driessen4, J.J. Cornelissen5, B.J.A. Rijnders1
4 5
1
6
the Netherlands.
7
2
8
Leuven, Department of Haematology, Leuven, Belgium.
9
3
KU Leuven- University of Leuven, Department of Microbiology and Immunology, Leuven, Belgium.
10
4
Erasmus University Medical Center, Sophia Children’s Hospital, subdepartment of Paediatric Infectious
11
Disease and Immunology, Rotterdam, the Netherlands.
12
5
Erasmus University Medical Center, Department of Internal Medicine, Infectious Diseases, Rotterdam,
KU Leuven- University of Leuven, Department of Microbiology and Immunology; University Hospitals
Erasmus University Medical Center, Department of Haematology, Rotterdam, the Netherlands.
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Running title: Galactomannan antigen testing in cerebrospinal fluid
15 16 17
#Corresponding author
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G.M. Chong, MD.
19
Department of Internal Medicine, Infectious Diseases.
20
Erasmus University Medical Center.
21
Room Na-922, PB2040, 3000 CA Rotterdam, the Netherlands.
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Email address: [email protected]
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Tel. +31644533371
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Fax. +31107033875
25
1
26
Manuscript category: Original article.
27
Abstract word count: 223.
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Text word count: 1680.
29
Table: 4 tables, 1 figure.
30
References: 7.
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Keywords: cerebral aspergillosis, galactomannan antigen testing, cerebrospinal fluid.
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2
33
Abstract
34 35
Introduction
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Testing cerebrospinal fluid (CSF) for the presence of galactomannan (GM) antigen may help in
37
diagnosing cerebral aspergillosis (CA). However, the use of CSF GM as a diagnostic test never been
38
validated. We evaluated its diagnostic performance by comparing the CSF GM levels at different cut-offs
39
in patients with probable and proven CA to those without CA.
40 41
Methods
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Patients from 2 tertiary referral hospitals with suspected CA between 2004-2014 and in whom CSF GM
43
had been determined, were selected. EORTC/MSG definitions of invasive aspergillosis and CA were
44
used but excluding the to-be-validated-test (=CSF GM) as a microbiological EORTC/MSG criterion.
45 46
Results
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The study population consisted of 44 patients (4 proven CA, 13 probable CA and 27 no CA). Of the 17
48
patients with CA, 15 had a CSF GM of ≥2.0. In patients without CA, 26 of the 27 had a CSF GM of
1
Diagnostic performance of galactomannan antigen testing in cerebrospinal fluid
2 3
G.M. Chong1#, J.A. Maertens2, K. Lagrou3, G.J. Driessen4, J.J. Cornelissen5, B.J.A. Rijnders1
4 5
1
6
the Netherlands.
7
2
8
Leuven, Department of Haematology, Leuven, Belgium.
9
3
KU Leuven- University of Leuven, Department of Microbiology and Immunology, Leuven, Belgium.
10
4
Erasmus University Medical Center, Sophia Children’s Hospital, subdepartment of Paediatric Infectious
11
Disease and Immunology, Rotterdam, the Netherlands.
12
5
Erasmus University Medical Center, Department of Internal Medicine, Infectious Diseases, Rotterdam,
KU Leuven- University of Leuven, Department of Microbiology and Immunology; University Hospitals
Erasmus University Medical Center, Department of Haematology, Rotterdam, the Netherlands.
13 14
Running title: Galactomannan antigen testing in cerebrospinal fluid
15 16 17
#Corresponding author
18
G.M. Chong, MD.
19
Department of Internal Medicine, Infectious Diseases.
20
Erasmus University Medical Center.
21
Room Na-922, PB2040, 3000 CA Rotterdam, the Netherlands.
22
Email address: [email protected]
23
Tel. +31644533371
24
Fax. +31107033875
25
1
26
Manuscript category: Original article.
27
Abstract word count: 223.
28
Text word count: 1680.
29
Table: 4 tables, 1 figure.
30
References: 7.
31
Keywords: cerebral aspergillosis, galactomannan antigen testing, cerebrospinal fluid.
32
2
33
Abstract
34 35
Introduction
36
Testing cerebrospinal fluid (CSF) for the presence of galactomannan (GM) antigen may help in
37
diagnosing cerebral aspergillosis (CA). However, the use of CSF GM as a diagnostic test never been
38
validated. We evaluated its diagnostic performance by comparing the CSF GM levels at different cut-offs
39
in patients with probable and proven CA to those without CA.
40 41
Methods
42
Patients from 2 tertiary referral hospitals with suspected CA between 2004-2014 and in whom CSF GM
43
had been determined, were selected. EORTC/MSG definitions of invasive aspergillosis and CA were
44
used but excluding the to-be-validated-test (=CSF GM) as a microbiological EORTC/MSG criterion.
45 46
Results
47
The study population consisted of 44 patients (4 proven CA, 13 probable CA and 27 no CA). Of the 17
48
patients with CA, 15 had a CSF GM of ≥2.0. In patients without CA, 26 of the 27 had a CSF GM of
