{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T06:08:00Z","timestamp":1784614080082,"version":"3.55.0"},"reference-count":34,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,2,3]],"date-time":"2025-02-03T00:00:00Z","timestamp":1738540800000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Mycoses"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Obtaining non\u2010directed samples from the upper bronchial tree is easier to perform and poses fewer risks for critically ill patients than deep bronchoalveolar lavage (BAL). Since invasive pulmonary aspergillosis is associated with a high mortality in critically ill patients, timely diagnosis and rapid initiation of treatment are of utmost importance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>The objective of this study was to compare Galactomannan (GM) testing by Enzyme Immunoassay (EIA), GM Lateral Flow Assay (LFA) and the detection of <jats:italic>Aspergillus<\/jats:italic> DNA by Polymerase Chain Reaction (PCR) between directed BAL and non\u2010directed bronchial lavage (BL) in critically ill patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this prospective, exploratory pilot study, we analysed 120 samples from 40 patients admitted to 12 mixed intensive care units. Inclusion criteria required either risk factors for IPA or positive <jats:italic>Aspergillus<\/jats:italic> assessments and met the criteria published by the European Society of Clinical Microbiology and Infectious Diseases guidelines for IPA diagnosis. Both respiratory secretions and blood were collected. In each patient, LFA and PCR were performed on BAL, BL and blood serum, respectively. The EIA test was applied to the BL and BAL of each patient, and the serum of 24 patients. The study was registered on <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">clinicaltrials.gov<\/jats:ext-link> (NCT04848831).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In a total of 80 respiratory samples, <jats:italic>Aspergillus<\/jats:italic> GM EIA yielded optical density indices (ODI) ranging from 0.04 to \u2265\u20093.5. We observed a high correlation between BAL and BL samples for <jats:italic>Aspergillus<\/jats:italic> GM EIA (Pearson's <jats:italic>r<\/jats:italic>\u2009=\u20090.78 [95% CI 0.62, 0.88]; intraclass correlation coefficient 0.78). At an ODI cutoff of 0.8 for BAL and 1.2 for BL, the sensitivity of <jats:italic>Aspergillus<\/jats:italic> GM EIA was 0.94, while the specificity was 0.67. Increasing the BAL cutoff to 1.0 ODI improved the specificity to 0.86. <jats:italic>Aspergillus<\/jats:italic> PCR examination showed good agreement between the two compartments, with a Cohen's kappa coefficient of 0.75 (95% CI 0.48, 1.00). The correlation of <jats:italic>Aspergillus<\/jats:italic> GM LFA between BAL and BL was weak.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our findings demonstrate that the detection of <jats:italic>Aspergillus<\/jats:italic> GM using EIA or <jats:italic>Aspergillus<\/jats:italic> PCR in BL is comparable to that in BAL. Thus, BL samples can be reliably used for diagnosing invasive pulmonary aspergillosis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/myc.70029","type":"journal-article","created":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T04:11:51Z","timestamp":1738642311000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Comparison of the Equivalence of <i>Aspergillus<\/i> Antigen and <scp>PCR<\/scp> Results Between Non\u2010Directed Bronchial Lavage and Bronchoalveolar Lavage\u2014A Prospective Exploratory Pilot Study in Critically Ill Patients"],"prefix":"10.1111","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1800-6462","authenticated-orcid":false,"given":"Maria","family":"Schroeder","sequence":"first","affiliation":[{"name":"Department of Intensive Care Medicine University Medical Center Hamburg\u2010Eppendorf  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamad Abd","family":"Raboh","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine University Medical Center Hamburg\u2010Eppendorf  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annika","family":"Nuechtern","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine University Medical Center Hamburg\u2010Eppendorf  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominic","family":"Wichmann","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine University Medical Center Hamburg\u2010Eppendorf  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Stamm","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine University Medical Center Hamburg\u2010Eppendorf  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4663-6931","authenticated-orcid":false,"given":"Tim","family":"Hardel","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine University Medical Center Hamburg\u2010Eppendorf  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Holger","family":"Rohde","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Virology and Hygiene University Medical Center Hamburg\u2010Eppendorf  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Christner","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Virology and Hygiene University Medical Center Hamburg\u2010Eppendorf  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann\u2010Kathrin","family":"Ozga","sequence":"additional","affiliation":[{"name":"Center for Experimental Medicine, Institute of Medical Biometry and Epidemiology University Medical Center Hamburg\u2010Eppendorf  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Steurer","sequence":"additional","affiliation":[{"name":"Center for Diagnostics, Institute of Pathology With the Sections Molecular Pathology and Cytopathology University Medical Center Hamburg\u2010Eppendorf  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Jafari","sequence":"additional","affiliation":[{"name":"Department of Clinical Infectious Diseases Research Center Borstel  Borstel Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans","family":"Klose","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine University Medical Center Hamburg\u2010Eppendorf  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Kluge","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine University Medical Center Hamburg\u2010Eppendorf  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcel","family":"Simon","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine University Medical Center Hamburg\u2010Eppendorf  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marlene","family":"Fischer","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine University Medical Center Hamburg\u2010Eppendorf  Hamburg 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in Progress: A New Real\u2010Life Approach for the Management of Critically ill COVID\u201019 Patients","volume":"10","author":"Carbonell N.","year":"2022","journal-title":"Biomedicine"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/myc.13789"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2010.02.012"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s001340050007"},{"issue":"1","key":"e_1_2_11_27_1","first-page":"15","article-title":"Epidemiologie, Diagnostik und Therapie erwachsener Patienten mit nosokomialer Pneumonie\u2014Update 2017","volume":"72","author":"Dalhoff 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