Diagnostic value of Galactomannan in Tracheobronchial Aspirate for Aspergillus infection in lung transplant recipients (the GALACTBAS study)
Monforte Pallares, Arnau (Universitat Autònoma de Barcelona. Departament de medicina)
Martin-Gomez, M. Teresa (Vall d'Hebron Institut de Recerca (VHIR))
Berastegui García, Cristina (Vall d'Hebron Institut de Recerca (VHIR))
Marquez-Algaba, Ester (Vall d'Hebron Institut de Recerca (VHIR))
Sacanell, Judith (Vall d'Hebron Institut de Recerca (VHIR))
Rosado Rodríguez, Joel (Vall d'Hebron Institut de Recerca (VHIR))
Falcó Roget, Anna (Vall d'Hebron Institut de Recerca (VHIR))
Escudero, Gonzalo (Vall d'Hebron Institut de Recerca (VHIR))
Casanovas, Jose (Vall d'Hebron Institut de Recerca (VHIR))
Kirkegaard, Cristina (Vall d'Hebron Institut de Recerca (VHIR))
Sáez-Giménez, Berta (Vall d'Hebron Institut de Recerca (VHIR))
Monforte, Víctor (Vall d'Hebron Institut de Recerca (VHIR))
Gavaldà, Joan (Vall d'Hebron Institut de Recerca (VHIR))
Len, Oscar (Universitat Autònoma de Barcelona. Departament de medicina)
Los-Arcos, Ibai (Vall d'Hebron Institut de Recerca (VHIR))

Date:	2026
Abstract:	Background: Lung transplant recipients (LTR) are highly susceptible to Aspergillus infection (AI), but diagnosis may be limited by the invasiveness of bronchoalveolar lavage fluid (BALF) collection. Proximal airway samples may provide a less invasive alternative. Methods: We conducted a retrospective single-center study including all adult LTR (March 2018 - March 2022) who underwent bronchoscopy with tracheobronchial aspirate (TBA) and BALF galactomannan (GM) testing in the same procedure. They were processed for mycological culture and EIA-based GM (Bio-Rad) after cysteine homogenization. AI was defined according to ISHLT consensus. A ROC curve for TBA GM and its diagnostic performance were assessed. Results: A total of 545 paired TBA-BALF samples from 282 LTR were analyzed. Proven or probable AI was diagnosed in 22 samples (4%). The optimal TBA GM cut-off was ≥0. 54 optical density index (ODI), yielding 95. 2% sensitivity, 92% specificity, and an AUC of 0. 97 (95% CI, 0. 95-0. 99). In comparison, BALF GM at ≥1. 0 ODI showed 33. 3% sensitivity and 99. 6% specificity (AUC 0. 88, 95% CI, 0. 80-0. 95), although BALF GM values were significantly higher in invasive infections compared with non-invasive infections (1. 49 vs. 0. 14; p-value = 0. 007). TBA cultures were more frequently positive than BALF (24% vs 9. 9%). Finally, TBA and BALF GM values demonstrated moderate correlation (r = 0. 54), and combined testing with concordant results improved accuracy to 99. 6%.
Rights:	Aquest material està protegit per drets d'autor i/o drets afins. Podeu utilitzar aquest material en funció del que permet la legislació de drets d'autor i drets afins d'aplicació al vostre cas. Per a d'altres usos heu d'obtenir permís del(s) titular(s) de drets.
Language:	Anglès
Document:	Article ; recerca ; Versió acceptada per publicar
Subject:	Fungal infection ; Lung transplantation ; 32 invasive aspergillosis ; Pulmonary
Published in:	Journal of Clinical Microbiology, 2026 , ISSN 1098-660X

Available from: 2099-01-01 Postprint 28 p, 926.0 KB

The record appears in these collections:
Articles > Research articles
Articles > Published articles