Sensitivity of serum galactomannan antigen in the diagnosis of invasive aspergillosis in patients with obstructive pulmonary diseases (asthma and chronic obstructive pulmonary diseases).

Abstract

Introduction: Adverse clinical outcomes often result from the concomitant presence of invasive pulmonary aspergillosis (IPA) in patients with obstructive pulmonary diseases (asthma and chronic obstructive pulmonary diseases (COPD)).

Aim: This work was developed to assess the risk factors (RFs) for patients with concurrent IPA and the diagnostic sensitivity of existing detection methods.

Material and methods: This was a case control study on patients with acute exacerbation of obstructive pulmonary diseases (OPD) hospitalized from January 2022 to December 2023; patients were categorized into an IPA group (n = 39) and a non-IPA group (n = 37) based on test results. Information about smoking history, diabetes history, usage of broad-spectrum antibiotics (BSAs) and corticosteroids, and serum albumin levels were collected. After univariate analysis, a multivariate logistic regression (MLR) analysis was performed. Additionally, the diagnostic sensitivity and specificity of GM antigen, IgG, and IgM detection were compared.

Results: Prolonged use of BSAs (≥ 2 weeks) and corticosteroids (≥ 3 weeks), along with low albumin levels emerged as independent RFs for concurrent IPA. The sensitivity of GM antigen detection (64.1%) was the highest among the three methods, with specificity slightly lower than IgG detection (75.68%, 81.08%), yet still not reaching the ideal level.

Conclusions: Risk assessment for asthma and COPD patients with concurrent IPA should encompass an evaluation of prolonged antibiotic and steroid use, along with a comprehensive consideration of nutritional and immune status. Current IPA detection methods should be evaluated in conjunction with clinical conditions to enhance diagnostic accuracy.