Real-life performance of a galactomannoprotein-detecting lateral flow immunoassay (AspLFD) in lower respiratory tract and serum specimens for screening pulmonary aspergillosis.

Rapid galactomannan/galactomannoprotein-detecting tests, such as the AspLFD, may be useful for diagnosis of invasive pulmonary aspergillosis (IPA). Nevertheless, further real-life experience needs to be accrued to validate this assumption. In the current, single-center, retrospective study we compared the analytical performance of the AspLFD assay with that of the Platelia GM enzyme-linked immunosorbent assay (Bio-Rad; Marnes-la-Cocquette, France) and between AspLFD and the Aspergillus Galactomannan antigen VIRCLIA® Monotest (Vircell S.L., Granada, Spain) in two different periods using serum and respiratory specimens, including bronchoalveolar lavage (BAL), bronchoaspirates (BAS) and endotracheal aspirates (TA), and assessed its clinical value for the diagnosis of IPA. A total of 231 samples (129 respiratory specimens-including 71 BAS, 27 TA, 24 BAL, and 7 sputum samples-and 102 serum samples) were obtained from 145 consecutive patients who were screened for PA at the physician's request. Proven/probable IPA cases (n = 32) and non-PA cases (n = 92) were considered to assess the clinical performance of the AspLFD assay. Overall, the rate of positive results-mainly in respiratory specimens-was comparable between the AspLFD (46.3%) and the GM Platelia assays (46.3%) and between the AspLFD (24.2%) and the GM VIRCLIA® assay (30.1%), although discrepancies were observed in 10-16% of the specimens. The overall sensitivity of the AspLFD assay was 78.1% (95% CI, 61.2-89.0), and the specificity was 80.9% (95% CI, 71.5-87.7). The AspLFD assay could be of value in classifying probable IPA, even when using respiratory specimens other than BAL. Future studies are warranted to validate this assumption.