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Register NowAspergillus Galactomannan Antigen Detection
Create a Free Account to View PricesTurnaround Time: 1 - 5 days
CPT Code:
87305
Test Type: 2 mL Serum or bronchoalveolar lavage (BAL)
Stability Time:
|
Temperature |
Period |
|---|---|
|
Room temperature |
Not stable (stability provided by manufacturer or literature reference) |
|
Refrigerated |
Unopened Serum: 5 days; Opened Serum: 48 hours; Unopened BAL: 24 hours (stability provided by manufacturer or literature reference) |
|
Frozen |
Serum: -70°C up to 5 months; BAL: -20°C or less up to 5 months (stability provided by manufacturer or literature reference) |
|
Freeze/thaw cycles |
Stable x4 (stability provided by manufacturer or literature reference) |
Overview:
Patients diagnosed with chronic granulomatous disease and/or Job's syndrome may yield a reduced detection of galactomannan.1 Reduced assay sensitivity may occur in patients receiving concomitant antifungal therapy.2 Penicillium species, Alternaria species, Paecilomyces species, Geotrichum species, and Histoplasma species have demonstrated reactivity with the monoclonal antibodies used in the assay and may, therefore, yield a positive test result. Positive results in patients with no clinical signs of disease have been reported, especially in young children.3 Most of these are considered to be false positives. Young children may have a positive assay result due to the presence of galactofuranaase contained in various foods (cereals) and milk. Patients receiving piperacillin/tazobactam or semisynthetic beta-lactamase therapy may have false-positive results.4,5 False-positive results may also occur with use of PLASMA-LYTE™ for either intravenous hydration or BAL specimen collection.6
A negative result does not exclude the possibility of invasive aspergillosis. Patients at risk for invasive aspergillosis should be tested twice weekly. Results close to the cutoff (ie, index of 0.5) should be interpreted with caution and supported by clinical, radiological, or laboratory culture results. BAL samples with an index value between 0.5 and 1.0 have a lower predictive value than those with a value >1.0.
1. Walsh TJ, Schaufele RL, Sein T. Abstracts of the 40th Annual Meeting of the Infectious Disease Society of America. Arlington, Va: 2002:1-5. Abstract 345.
2. Marr KA, Laverdiere M, Gugel A, Leisenring W. Antifungal therapy decreases sensitivity of the Aspergillus Galactomannan enzyme immunoassay. Clin Infect Dis. 2005 Jun 15; 40(12):1762-1769. PubMed 15909264
3. Siemann M, Koch-Dörfler M, Gaude M. False-positive results in premature infants with the Platelia Aspergillus sandwich enzyme-linked immunosorbent assay. Mycoses. 1998 Nov; 41(9-10):373-377. PubMed 9916459
4. Viscoli C, Machetti P, Cappellano P, et al. False-positive Galactomannan platelia Aspergillus test results for patients receiving piperacillin-tazobacter. Clin Infect Dis. 2004 Mar 15; 38(6):913-916. PubMed 14999640
5. Bart-Delabesse E, Basile M, Al Jijakli A, et al. Detection of Aspergillus galactomannan antigenemia to determine biological and clinical implications of beta-lactam treatments.J Clin Microbiol. 2005 Oct; 43(10):5214-5220. PubMed 16207986
6. Hage CA, Reynolds JM, Durkin M, Wheat LJ, Knox KS. Plasmalyte as a cause of false-positive results for Aspergillusgalactomannan in bronchoalveolar lavage fluid. J Clin Microbiol. 2007 Feb; 45(2):675-677. PubMed 17166959
Alexander BD, Pfaller MA. Contemporary tools for the diagnosis and management of invasive mycoses. CID 2006; 43(Suppl 1):S15-S27.
Gentry LO, Wilkinson ID, Lea AS, Price MF. Latex agglutination test for detection of Candida antigen in patients with disseminated disease. Eur J Clin Microbiol. 1983 Apr; 2(2):122-128. PubMed 6861734
Pinel C, Fricker-Hildalgo B, Lebeau B, et al. Detection of circulating Aspergillus fumigatus galactomannan: Value and limits of the Platelia test for diagnosing invasive aspergillosis. J Clin Microbiol. 2003 May; 41(5):2184-2186. PubMed 12734275
Collection Details:
Patient Preparation:
Usual aseptic technique.
Collection Instructions:
Serum: Red-top tube or gel-barrier tube; BAL: sterile screw-cap, leakproof container
Collect specimen using aseptic technique. Avoid opening the specimen after collection to prevent contamination with fungal spores and/or bacteria present in the environment.
Serum: Refrigerate unopened for up to five days. Separated serum may be frozen at -70°C. BAL: Refrigerate up to 24 hours. Frozen (-20°C or colder) for up to five months.