Mycological and Serological Study of Invasive Aspergillosis in A Tertiary Care Hospital

Objectives: Invasive aspergillosis (IA) has emerged as a major life threatening infection in high risk patients. Recent advances have led to early diagnosis of IA by detecting Aspergillus antigens in serum particularly Galactomannan (GM). Objective of the study was to correlate fungal smear, culture and Galactomannan assay in patients with suspected IA and to categorize them into “proven,” “probable,” and “possible,” cases as per European Organization for Research and Treatment of Cancer and Mycoses study group case definitions (EORTC/MSG) criteria. Methods: The prospective study was conducted over a period of one year in the department of Microbiology, Dayanand Medical College and Hospital, Ludhiana. A total of 319 patients with suspicion of IA were included in the study. GM antigen detection test was done from serum samples. KOH mount was done and samples were inoculated on Sabouraud’s dextrose agar (SDA). Growth obtained was analyzed as per standard protocol. Results: GM assay positivity among suspected patients of IA was 47%. The mean age group affected was 51.8 years (51.8±15.2) and majority was males (78.1%). The patients were categorized as Proven IA (0%), Probable IA (52.7%), Possible IA (41.4%) and No IA (5.9%). Aspergillus flavus was the most common isolate (77.4%) Conclusion: The study demonstrated that serological tests have an edge over routine smear and culture for the diagnosis of invasive aspergillosis. Thus, Galactomannan assay is a useful diagnostic for early detection of IA in high risk patients. J Microbiol Infect Dis 2018; 8(1):8-12

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