Rapid Fungal Diagnostics
Lateral flow assays give the laboratory the means to provide diagnostic guidance to clinicians quickly.
The Manchester mycology group evaluated a qualitative lateral flow assay for IgG and IgM antibodies to Aspergillus with promising results. although a qualitative rather than a quantitative test. High specificity makes it a valuable screening test.
Likewise, the LFAs from ERA Biology for Aspergillus galactomannan, Candida mannan and Cryptococcal capsular polysaccharide could provide the prompt support that clinicians are looking for.
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Invasive fungal disease occurs often in critically ill patients with COVID-19 on mechanical ventilation, according to a study published in Clinical Infectious Diseases
A national strategy to diagnose COVID-19 associated invasive fungal disease in the ICU.
Nine patients with CoVID-19 and invasive pulmonary aspergillosis were recently described in France (33% of 27 admitted to the ICU with CoVID-19),4 and five in Germany (26% of 19 admitted).
Confronting and mitigating the risk of COVID-19 Associated Pulmonary Aspergillosis (CAPA)
Chronic Pulmonary Aspergillosis—Where Are We? and Where Are We Going?
'The use of Aspergillus IgG antibody as a diagnostic tool is far superior to the use of Aspergillus precipitins and should always be used as the gold standard ..to confirm infection.'
J. Fungi 2016, 2(2), 18; https://doi.org/10.3390/jof2020018
Evaluation of LDBio Aspergillus ICT Lateral Flow Assay for IgG and IgM Antibody Detection in Chronic Pulmonary Aspergillosis
A total of 154 CPA patient sera collected at the National Aspergillosis Centre (Manchester, United Kingdom) and control patient sera from the Peninsula Research Bank (Exeter, United Kingdom) were evaluated.
The LDBIO Aspergillus ICT IgG-IgM immunochromatographic technology (ICT) test was compared with Aspergillus IgG titers in CPA patients, measured by ImmunoCAP-specific IgG assays (cutoff value, 40 mg of antigen-specific antibodies [mgA]/liter
For proven CPA patients versus controls, sensitivity and specificity for the LDBio Aspergillus ICT were 91.6% and 98.0%, respectively. In contrast, the routinely used ImmunoCAP assay exhibited 80.5% sensitivity for the same cohort
Of the 154 patients in our CPA case group, 108 had precipitins testing (for Aspergillus antibody) performed as part of routine diagnostics, with 57.4% sensitivity.
Our evaluation has shown very good sensitivity (91.6%) and specificity (98.0%) for diagnosis of CPA in United Kingdom patients, with the ICT test significantly outperforming our workhorse assay—the ImmunoCAP test.
Journal of Clinical Microbiology Aug 2019, 57 (9) e00538-19; DOI: 10.1128/JCM.00538-19
Evaluation of the LDBio Aspergillus ICT lateral flow assay for serodiagnosis of allergic bronchopulmonary aspergillosis.
Early recognition and diagnosis of allergic bronchopulmonary aspergillosis (ABPA) is critical
to improve patient symptoms, and antifungal therapy may prevent or delay progression of
bronchiectasis and development of chronic pulmonary aspergillosis.
ABPA and control sera collected at the National Aspergillosis Centre (Manchester, UK) and/or from the Manchester Allergy, Respiratory and Thoracic Surgery research biobank were evaluated using the Aspergillus ICT assay. Results were read both visually and digitally (using a lateral flow reader). Serological Aspergillus-specific IgG and IgE, and total IgE titres were measured by ImmunoCAP.
Serological tests are a useful tool for early detection of ABPA and comprise a significant portion of the recently suggested guidelines for ABPA diagnosis ,
In relation to Aspergillus species detected in sputum from ABPA patients (Table 3), the ICT performed well in detecting Asp antibodies for cases with A. fumigatus isolated alone (97.2% sensitivity) as well as for cases where non-A. fumigatus species were isolated in addition (95.2% sensitivity),
In this study of clinically confirmed cases of ABPA compared to diseased controls, we found the LDBio Aspergillus ICT to have good sensitivity and specificity. The test effectively distinguished between Aspergillus-sensitization complicating asthma and/or bronchiectasis, and underlying conditions. It is rapid (result in <30 minutes) and easy to perform, with simple result interpretation by visible inspection. Overall, the LDBio Aspergillus ICT exhibits excellent performance as a screening tool in the ABPA diagnostic pathway
Published: September 25, 2020 https://doi.org/10.1371/journal.pone.0238855