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

Abstract

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