Academic Journal
Impact of posaconazole prophylaxis and antifungal treatment on BAL GM performance in hematology malignancy patients with febrile neutropenia: A real life experience
| العنوان: | Impact of posaconazole prophylaxis and antifungal treatment on BAL GM performance in hematology malignancy patients with febrile neutropenia: A real life experience |
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| المؤلفون: | Acet-Öztürk, Nilüfer Aylin, Ömer-Topcu, Dilara, Vurat Acar, Kübra, Aydın-Güçlü, Özge, Pınar, İbrahim Ethem, Demirdoğen, Ezgi, Görek-Dilektasli, Aslı, Kazak, Esra, Özkocaman, Vildan, Ursavaş, Ahmet, Özkalemkaş, Fahir, Ener, Beyza, Ali, Rıdvan, Akalın, Halis |
| المساهمون: | Bursa Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Hastalıkları Anabilim Dalı., Bursa Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı., Bursa Uludağ Üniversitesi/Tıp Fakültesi/Hematoloji Anabilim Dalı., Bursa Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı., Bursa Uludağ Üniversitesi/Tıp Fakültesi/Mikrobiyoloji Anabilim Dalı., orcid:0000-0002-6375-1472, orcid:0000-0002-7400-9089, orcid:0000-0001-7530-1279, ACET ÖZTÜRK, NİLÜFER AYLİN, ÖMER TOPÇU, DİLARA, VURAT ACAR, KÜBRA, AYDIN GÜÇLÜ, ÖZGE, PINAR, İBRAHİM ETHEM, DEMİRDÖĞEN, EZGİ, GÖREK DİLEKTAŞLI, ASLI, KAZAK, ESRA, ÖZKOCAMAN, VİLDAN, URSAVAŞ, AHMET, ÖZKALEMKAŞ, FAHİR, ENER, BEYZA, ALİ, RIDVAN, AKALIN, EMİN HALİS, AAI-3169-2021, JGM-6601-2023, Z-1424-2019, AAH-9812-2021, AAU-8952-2020, AAG-8459-2021, FRE-8778-2022, JQQ-5505-2023, GXD-8045-2022, JHW-9355-2023, FQG-8981-2022, JIW-1248-2023, CNK-0895-2022, GXD-8209-2022 |
| بيانات النشر: | Springer |
| سنة النشر: | 2023 |
| المجموعة: | Açık Erişim@BUU (Bursa Uludağ Üniversitesi) |
| مصطلحات موضوعية: | Bronchoalveolar lavage fluid, Invasive pulmonary aspergillosis, Infectious-diseases society, Galactomannan enzyme-immunoassay, Practice guidelines, Diagnosis, Management, Assay, Sensitivity, Kinetics, Galactomannan diagnostic performance, Bronchoalveolar lavage, Antifungal therapy, Infectious diseases, Microbiology |
| الوصف: | BackgroundDiagnostic accuracy of galactomannan measurements is highly variable depending on the study population, diagnostic procedures, and treatment procedures. We aimed to evaluate the effect of posaconazole prophylaxis and empiric antifungal treatment upon diagnostic accuracy of GM measurements in bronchoalveolar lavage (BAL), bronchial lavage (BL), and serum in hematological malignancy population.MethodsPatients hospitalized in a single tertiary care center with hematologic malignancies undergoing fiberoptic bronchoscopy (FOB) with a preliminary diagnosis of IPA were retrospectively included.ResultsIn all the study population (n = 327), AUC for BAL, BL, and serum GM were as follows: 0.731 [0.666-0.790], 0.869 [0.816-0.912], and 0.610 [0.540-0.676] with BL samples having the best diagnostic value. GM measurements in patients under posaconazole prophylaxis (n = 114) showed similar diagnostic performance. While specificity was similar between patients with and without posaconazole prophylaxis, sensitivity of GM measurements was lower in patients with prophylaxis. Analyses with patient classified according to antifungal treatment at the time of FOB procedure (n = 166) showed a decreased diagnostic accuracy in serum GM and BAL GM measurements related with the duration of treatment. However, BAL, BL, and serum GM measurements presented similar sensitivity and specificity in higher cut-off values in longer durations of antifungal treatment.ConclusionOur study shows that posaconazole prophylaxis and active short-term (3 days) antifungal treatment do not significantly affect overall diagnostic performance of GM measurements in bronchoalveolar lavage and bronchial lavage samples. However, using different cut-off values for patients receiving active treatment might be suggested to increase sensitivity. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| تدمد: | 0934-9723 |
| Relation: | Makale - Uluslararası Hakemli Dergi; European Journal of Clinical Microbiology & Infectious Diseases; https://doi.org/10.1007/s10096-023-04686-7; https://link.springer.com/article/10.1007/s10096-023-04686-7; https://hdl.handle.net/11452/44394; 001096591600001; 33; 43 |
| DOI: | 10.1007/s10096-023-04686-7 |
| الاتاحة: | https://hdl.handle.net/11452/44394 https://doi.org/10.1007/s10096-023-04686-7 https://link.springer.com/article/10.1007/s10096-023-04686-7 |
| Rights: | info:eu-repo/semantics/closedAccess |
| رقم الانضمام: | edsbas.123C21EA |
| قاعدة البيانات: | BASE |
| تدمد: | 09349723 |
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| DOI: | 10.1007/s10096-023-04686-7 |