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Single-centre retrospective cohort study (2011-2012; Austria)

1 of 2. Lateral flow device (LFD) test on bronchoalveolar lavage (BAL) samples for diagnosing invasive pulmonary aspergillosis (IPA): diagnostic accuracy. Single-centre retrospective cohort study (2011-2012; Austria) N=56 BAL samples from 54 patients routinely tested for galactomannan (GM):

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Single-centre retrospective cohort study (2011-2012; Austria)

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  1. 1 of 2 Lateral flow device (LFD) test on bronchoalveolar lavage (BAL) samples for diagnosing invasive pulmonary aspergillosis (IPA): diagnostic accuracy Single-centre retrospective cohort study (2011-2012; Austria) N=56 BAL samples from 54 patients routinely tested for galactomannan (GM): Haematological malignancies: N=34 Solid organ transplantation: N=10 HIV: N=2 COPD: N=9 H1N1 influenza: N=1 BAL-LFD: Single sample point-of-care test based on detection of an Aspergillus extracellular glycoprotein antigen by monoclonal antibody JF5 Hoenigl M. ECCMID 2013 abs. O159

  2. 2 of 2 Lateral flow device (LFD) test on bronchoalveolar lavage (BAL) samples for diagnosing invasive pulmonary aspergillosis (IPA): diagnostic accuracy • Sensitivity for probable IPA: 15/15 = 100% • Specificity for probable IPA: (5+28)/(13+28) = 80% • GM level in BAL-LFD neg. pts < GM level in BAL-LFD pos. pts (P<0.0001) • 8 false positives: had received mould active antifungal therapy at time of BAL sampling The LFD test of BAL specimens seems to be an easy and rapid diagnostic approach for detecting IPA with good diagnostic accuracy Hoenigl M. ECCMID 2013 abs. O159

  3. 1 of 2 Usefulness of previous clinical isolates for predicting identity and susceptibility of subsequent infecting isolates Single-centre retrospective cohort study (2010-2012): N=1,511 adult patients with ≥2 positive clinical isolates from the same source (data from Stewardship Program Integrated Resource Information Technology database) 6,743 pairs of positive isolates identified: Urine: 3,938 − Blood: 1,604 − Respiratory: 1,201 Organism identity Likelihood of organism correspondence: Linear decline in function of time for urinary/blood isolates, but no decline for respiratory isolates MacFadden D. ECCMID 2013 abs. P959 Data from poster

  4. 2 of 2 Usefulness of previous clinical isolates for predicting identity and susceptibility of subsequent infecting isolates Antibiotic susceptibility • Likelihood of susceptibility correspondence: Linear decline in function of time: • Respiratory samples not useful if >1 month time lapse between paired isolated • Urine cultures remain valuable at all time points • Blood samples not useful if >8 month time lapse between paired isolates Multivariable regression :Intervening treatment with antibiotics and documentation of negative cultures may predict decreased organism/susceptibility correspondence A patient’s prior isolates may predict identity (esp. respiratory isolates) and susceptibility (esp. urinary isolates) of subsequent isolates MacFadden D. ECCMID 2013 abs. P959 Data from poster

  5. Fungiscope: a global online database for rare invasive fungal diseases (IFD) • Fungiscope: Global Emerging Fungal Infection Registry (www.fungiscope.net) • N=299 cases; inclusion criteria: cultural, histopathological, antigen, or molecular genetic evidence of IFD • Complete or partial response to treatment: 53.8% • Overall mortality: 43.8% − Mortality due to IFD: 32.1% Data from this global IFD registry may broaden our knowledge on the epidemiology, clinical patterns, diagnosis and treatment of rare IFD Wahlers K. ECCMID 2013 abs. P1052

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