Clinical diagnostic value of combined detection of serum and bronchoalveolar lavage fluid galactomannan for invasive pulmonary aspergillosis in non-neutropenic children / 中华微生物学和免疫学杂志

ABSTRACT

Objective:To investigate the clinical diagnostic value of combined detection of serum and bronchoalveolar lavage fluid (BALF) galactomannan (GM) for invasive pulmonary aspergillosis (IPA) in children with non-neutropenia.Methods:An analysis was made on 100 children with non-neutropenia suspected of invasive pulmonary aspergillosis in the respiratory ward of the Children′s Hospital Affiliated to Capital Institute of Pediatrics from January 2019 to March 2020. All of them were tested by serum and BALF GM tests as well as sputum and BALF culture for fungi. The sensitivity, specificity and accuracy of serum and BALF GM in the diagnosis of IPA in non-neutropenic children were analyzed. The receiver operating characteristic (ROC) curve and the area under the ROC curve (AUC) were used to evaluate the clinical diagnostic value of serum and BALF GM tests for IPA in children with non-neutropenia.Results:The recruited 100 cases included one confirmed case, 85 clinically diagnosed cases and two suspected cases, while the 12 cases were excluded. The accuracy and 95% confidence interval (95%CI) of serum and BALF GM tests used alone and in combination in the clinical diagnosis of IPA in non-neutropenic children were 29.0% (95%CI 20.1%-37.9%), 75.0% (95%CI 66.5%-83.5%) and 81.0% (95%CI 73.3%-88.7%), respectively. The AUC and 95%CI were 0.645 (95%CI 0.513-0.778), 0.785 (95%CI 0.644-0.926) and 0.819 (95%CI 0.681-0.953), respectively.Conclusions:The combined detection of serum and BALF GM was better than a single indicator in the clinical diagnosis of IPA in non-neutropenic children, suggesting the combined detection was of great value in clinical diagnosis.