{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T09:04:54Z","timestamp":1784365494402,"version":"3.55.0"},"reference-count":12,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2023,2,4]],"date-time":"2023-02-04T00:00:00Z","timestamp":1675468800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,2,4]],"date-time":"2023-02-04T00:00:00Z","timestamp":1675468800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"University of Dublin, Trinity College"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Infection"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>Invasive aspergillosis is a major threat to immunocompromised individuals. Galactomannan (GM) is used as a biomarker for invasive aspergillosis. Investigations recommended in current guidelines include GM testing of bronchoalveolar lavage (BAL) fluids. GM testing of endotracheal aspirate, the sampling of which is less invasive, less resource-intensive and less aerosol-generating, is not validated. We compared the performance of endotracheal aspirate GM as a screening tool to predict BAL fluid GM-positivity in patients with suspected invasive aspergillosis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Of each patient, a pair of corresponding endotracheal aspirate and BAL fluid samples was tested and compared for GM results. Two sample sets were included. The first consisted of 140 consecutive BAL fluid\/endotracheal aspirate pairs obtained from 133 patients. The pairs of the second sample set (<jats:italic>n\u2009=\u2009<\/jats:italic>38) were selected based on the criterion that the BAL tested positive for GM. All specimens were obtained in a German 2,000 bed tertiary care center.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Among BAL fluid GM-positive samples, endotracheal aspirate GM demonstrated poor specificity (72%) but high sensitivity (92% in predicting BAL fluid GM of\u2009\u2265\u20090.50 and 91% for BAL fluid GM of\u2009\u2265\u20091.00) and an excellent negative predictive value (98%). The use of a marginally elevated cutoff of 0.63 resulted in an improved specificity (72\u201381%), without loss of sensitivity.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>For screening purposes, one might consider testing endotracheal aspirate for GM, which could help avoid unnecessary BAL.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s15010-023-01985-1","type":"journal-article","created":{"date-parts":[[2023,2,4]],"date-time":"2023-02-04T11:03:09Z","timestamp":1675508589000},"page":"769-774","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Performance of galactomannan testing from endotracheal aspirate to guide bronchoalveolar lavage in the diagnosis of invasive aspergillosis"],"prefix":"10.1007","volume":"51","author":[{"given":"Karl","family":"Dichtl","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Barry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias W. A.","family":"Angstwurm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Suerbaum","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5952-9422","authenticated-orcid":false,"given":"Johannes","family":"Wagener","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,2,4]]},"reference":[{"key":"1985_CR1","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.1016\/j.cmi.2018.01.002","volume":"24","author":"AJ Ullmann","year":"2018","unstructured":"Ullmann AJ, Aguado JM, Arikan-Akdagli S, Denning DW, Groll AH, Lagrou K, et al. Diagnosis and management of Aspergillus diseases: executive summary of the 2017 ESCMID-ECMM-ERS guideline. Clin Microbiol Infect. 2018;24:e1\u201338.","journal-title":"Clin Microbiol Infect"},{"key":"1985_CR2","doi-asserted-by":"publisher","first-page":"1696","DOI":"10.1093\/cid\/ciu673","volume":"59","author":"RF Duarte","year":"2014","unstructured":"Duarte RF, S\u00e1nchez-Ortega I, Cuesta I, Arnan M, Pati\u00f1o B, Fern\u00e1ndez-de-Sevilla A, et al. Serum galactomannan-based early detection of invasive aspergillosis in hematology patients receiving effective antimold prophylaxis. Clin Infect Dis. 2014;59:1696\u2013702.","journal-title":"Clin Infect Dis"},{"key":"1985_CR3","doi-asserted-by":"publisher","first-page":"1417","DOI":"10.1086\/503427","volume":"42","author":"CD Pfeiffer","year":"2006","unstructured":"Pfeiffer CD, Fine JP, Safdar N. Diagnosis of invasive aspergillosis using a galactomannan assay: a meta-analysis. Clin Infect Dis. 2006;42:1417\u201327.","journal-title":"Clin Infect Dis"},{"key":"1985_CR4","doi-asserted-by":"publisher","first-page":"145","DOI":"10.5603\/AIT.2014.0027","volume":"46","author":"S Teering","year":"2014","unstructured":"Teering S, Verreth A, Peeters A, Van Regenmortel N, De Laet I, Schoonheydt K, et al. Prognostic value of serum galactomannan in mixed ICU patients: a retrospective observational study. Anaesthesiol Intensive Ther. 2014;46:145\u201354.","journal-title":"Anaesthesiol Intensive Ther"},{"key":"1985_CR5","doi-asserted-by":"publisher","first-page":"433","DOI":"10.1093\/cid\/ciw444","volume":"63","author":"TF Patterson","year":"2016","unstructured":"Patterson TF, Thompson GR, Denning DW, Fishman JA, Hadley S, Herbrecht R, et al. Executive summary: practice guidelines for the diagnosis and management of Aspergillosis: 2016 Update by the Infectious Diseases Society of America. Clin Infect Dis. 2016;63:433\u201342.","journal-title":"Clin Infect Dis"},{"key":"1985_CR6","doi-asserted-by":"publisher","first-page":"49","DOI":"10.21037\/atm.2019.01.21","volume":"7","author":"R Choo","year":"2019","unstructured":"Choo R, Anantham D. Role of bronchoalveolar lavage in the management of immunocompromised patients with pulmonary infiltrates. Ann Transl Med. 2019;7:49.","journal-title":"Ann Transl Med"},{"key":"1985_CR7","doi-asserted-by":"publisher","first-page":"1367","DOI":"10.1093\/cid\/ciz1008","volume":"71","author":"JP Donnelly","year":"2020","unstructured":"Donnelly JP, Chen SC, Kauffman CA, Steinbach WJ, Baddley JW, Verweij PE, et al. Revision and update of the consensus definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer and the Mycoses Study Group Education and Research Consortium. Clin Infect Dis. 2020;71:1367\u201376.","journal-title":"Clin Infect Dis"},{"key":"1985_CR8","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0043347","volume":"7","author":"M Zou","year":"2012","unstructured":"Zou M, Tang L, Zhao S, Zhao Z, Chen L, Chen P, et al. Systematic review and meta-analysis of detecting galactomannan in bronchoalveolar lavage fluid for diagnosing invasive aspergillosis. PLoS ONE. 2012;7: e43347.","journal-title":"PLoS ONE"},{"key":"1985_CR9","doi-asserted-by":"publisher","first-page":"463","DOI":"10.1007\/s12185-009-0429-8","volume":"90","author":"SI Kimura","year":"2009","unstructured":"Kimura SI, Odawara J, Aoki T, Yamakura M, Takeuchi M, Matsue K. Detection of sputum Aspergillus galactomannan for diagnosis of invasive pulmonary aspergillosis in haematological patients. Int J Hematol. 2009;90:463\u201370.","journal-title":"Int J Hematol"},{"key":"1985_CR10","doi-asserted-by":"publisher","first-page":"5","DOI":"10.15761\/PCCM.1000114","volume":"1","author":"J Vazquez","year":"2016","unstructured":"Vazquez J, Tovar-Torres M, Hingwe A, Cheema F, Welch V, Ford K. The changing epidemiology of invasive aspergillosis in the non-traditional host: risk factors and outcomes. Pulm Crit Care Med. 2016;1:5.","journal-title":"Pulm Crit Care Med"},{"key":"1985_CR11","doi-asserted-by":"publisher","first-page":"e149","DOI":"10.1016\/S1473-3099(20)30847-1","volume":"21","author":"P Koehler","year":"2021","unstructured":"Koehler P, Bassetti M, Chakrabarti A, Chen SCA, Colombo AL, Hoenigl M, et al. Defining and managing COVID-19-associated pulmonary aspergillosis: the 2020 ECMM\/ISHAM consensus criteria for research and clinical guidance. Lancet Infect Dis. 2021;21:e149\u201362.","journal-title":"Lancet Infect Dis"},{"key":"1985_CR12","doi-asserted-by":"publisher","first-page":"353","DOI":"10.1111\/j.1439-0507.1997.tb00249.x","volume":"40","author":"R Ansorg","year":"1997","unstructured":"Ansorg R, van den Boom R, Rath PM. Detection of Aspergillus galactomannan antigen in foods and antibiotics. Mycoses. 1997;40:353\u20137.","journal-title":"Mycoses"}],"container-title":["Infection"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s15010-023-01985-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s15010-023-01985-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s15010-023-01985-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,23]],"date-time":"2023-05-23T18:38:19Z","timestamp":1684867099000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s15010-023-01985-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,4]]},"references-count":12,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2023,6]]}},"alternative-id":["1985"],"URL":"https:\/\/doi.org\/10.1007\/s15010-023-01985-1","relation":{},"ISSN":["0300-8126","1439-0973"],"issn-type":[{"value":"0300-8126","type":"print"},{"value":"1439-0973","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,4]]},"assertion":[{"value":"6 July 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 January 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 February 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors have disclosed that they do not have any conflicts of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This retrospective study was reviewed and approved by the ethics committee of the University Hospital of LMU Munich (Ethikkommission bei der Medizinischen Fakult\u00e4t der LMU M\u00fcnchen; no. 17-565; 20\/16\/06) and conducted in accordance with the Declaration of Helsinki.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Not applicable. This retrospective study was performed with anonymized residuals from diagnostic specimens. A waiver for informed consent was granted.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"Not applicable. This retrospective study was performed with anonymized residuals from diagnostic specimens. A waiver for informed consent was granted.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to publish"}}]}}