biostudies-literatureUnknown64(4)Roman-Montes CM<h4>Objective</h4>Our aim was to evaluate the performance of two galactomannan (GM) assays (Platelia Aspergillus EIA, Bio-Rad^® , and Aspergillus GM LFA, IMMY^® ) in tracheal aspirate (TA) samples of consecutive critically ill patients with COVID-19.<h4>Methods</h4>We included critically ill patients, performed GM-EIA and GM-Lateral Flow Assay (GM-LFA) in TA and followed them until development of COVID-19-associated pulmonary aspergillosis (CAPA) or alternate diagnosis. CAPA was defined according to the modified AspICU criteria in patients with SARS-CoV-2 infection. We estimated sensitivity, specificity, positive and negative predictive values for GM-EIA, GM-LFA, the combination of both or either positive results for GM-EIA and GM-LFA. We explored accuracy using different breakpoints, through ROC analysis and Youden index to identify the optimal cut-offs. We described antifungal treatment and 30-day mortality.<h4>Results</h4>We identified 14/144 (9.7%) patients with CAPA, mean age was 50.35 (SD 11.9), the median time from admission to CAPA was 8 days; 28.5% received tocilizumab and 30-day mortality was 57%. ROC analysis and Youden index identified 2.0 OD as the best cut-off, resulting in sensitivity and specificity of 57.1% and 81.5% for GM-EIA and 60% and 72.6% for GM-LFA, respectively.<h4>Conclusions</h4>The diagnostic performance of GM in tracheal aspirates improved after using a cut-off of 2 OD. Although bronchoalveolar lavage testing is the ideal test, centres with limited access to bronchoscopy may consider this approach to identify or rule out CAPA.Mycoses364-371https://www.ebi.ac.uk/biostudies/studies/S-EPMC7753336biostudies-literatureAccuracy of galactomannan testing on tracheal aspirates in COVID-19-associated pulmonary aspergillosis.PMC7753336Martinez-Gamboa ARoman-Montes CMRangel-Cordero AGonzalez-Lara MFCervantes-Sanchez APonce-de-Leon ASifuentes-Osornio JDiaz-Lomeli PfalseAccuracy of galactomannan testing on tracheal aspirates in COVID-19-associated pulmonary aspergillosis.<h4>Objective</h4>Our aim was to evaluate the performance of two galactomannan (GM) assays (Platelia Aspergillus EIA, Bio-Rad^® , and Aspergillus GM LFA, IMMY^® ) in tracheal aspirate (TA) samples of consecutive critically ill patients with COVID-19.<h4>Methods</h4>We included critically ill patients, performed GM-EIA and GM-Lateral Flow Assay (GM-LFA) in TA and followed them until development of COVID-19-associated pulmonary aspergillosis (CAPA) or alternate diagnosis. CAPA was defined according to the modified AspICU criteria in patients with SARS-CoV-2 infection. We estimated sensitivity, specificity, positive and negative predictive values for GM-EIA, GM-LFA, the combination of both or either positive results for GM-EIA and GM-LFA. We explored accuracy using different breakpoints, through ROC analysis and Youden index to identify the optimal cut-offs. We described antifungal treatment and 30-day mortality.<h4>Results</h4>We identified 14/144 (9.7%) patients with CAPA, mean age was 50.35 (SD 11.9), the median time from admission to CAPA was 8 days; 28.5% received tocilizumab and 30-day mortality was 57%. ROC analysis and Youden index identified 2.0 OD as the best cut-off, resulting in sensitivity and specificity of 57.1% and 81.5% for GM-EIA and 60% and 72.6% for GM-LFA, respectively.<h4>Conclusions</h4>The diagnostic performance of GM in tracheal aspirates improved after using a cut-off of 2 OD. Although bronchoalveolar lavage testing is the ideal test, centres with limited access to bronchoscopy may consider this approach to identify or rule out CAPA.2021-01-01T00:00:00Z2021 Apr2025-04-22T06:53:19.893Z2025-04-05T21:54:28.115ZS-EPMC77533363321778410.1111/myc.13216