Publication:
Impact of posaconazole prophylaxis and antifungal treatment on BAL GM performance in hematology malignancy patients with febrile neutropenia: A real life experience

dc.contributor.authorAcet-Öztürk, Nilüfer Aylin
dc.contributor.authorÖmer-Topcu, Dilara
dc.contributor.authorVurat Acar, Kübra
dc.contributor.authorAydın-Güçlü, Özge
dc.contributor.authorPınar, İbrahim Ethem
dc.contributor.authorDemirdoğen, Ezgi
dc.contributor.authorGörek-Dilektasli, Aslı
dc.contributor.authorKazak, Esra
dc.contributor.authorÖzkocaman, Vildan
dc.contributor.authorUrsavaş, Ahmet
dc.contributor.authorÖzkalemkaş, Fahir
dc.contributor.authorEner, Beyza
dc.contributor.authorAli, Rıdvan
dc.contributor.authorAkalın, Halis
dc.contributor.buuauthorACET ÖZTÜRK, NİLÜFER AYLİN
dc.contributor.buuauthorÖMER TOPÇU, DİLARA
dc.contributor.buuauthorVURAT ACAR, KÜBRA
dc.contributor.buuauthorAYDIN GÜÇLÜ, ÖZGE
dc.contributor.buuauthorPINAR, İBRAHİM ETHEM
dc.contributor.buuauthorDEMİRDÖĞEN, EZGİ
dc.contributor.buuauthorGÖREK DİLEKTAŞLI, ASLI
dc.contributor.buuauthorKAZAK, ESRA
dc.contributor.buuauthorÖZKOCAMAN, VİLDAN
dc.contributor.buuauthorURSAVAŞ, AHMET
dc.contributor.buuauthorÖZKALEMKAŞ, FAHİR
dc.contributor.buuauthorENER, BEYZA
dc.contributor.buuauthorALİ, RIDVAN
dc.contributor.buuauthorAKALIN, EMİN HALİS
dc.contributor.departmentTıp Fakültesi
dc.contributor.departmentHematoloji Ana Bilim Dalı
dc.contributor.orcid0000-0002-6375-1472
dc.contributor.orcid0000-0002-7400-9089
dc.contributor.orcid0000-0001-7530-1279
dc.contributor.researcheridAAI-3169-2021
dc.contributor.researcheridJGM-6601-2023
dc.contributor.researcheridZ-1424-2019
dc.contributor.researcheridAAH-9812-2021
dc.contributor.researcheridAAU-8952-2020
dc.contributor.researcheridAAG-8459-2021
dc.contributor.researcheridFRE-8778-2022
dc.contributor.researcheridJQQ-5505-2023
dc.contributor.researcheridGXD-8045-2022
dc.contributor.researcheridJHW-9355-2023
dc.contributor.researcheridFQG-8981-2022
dc.contributor.researcheridJIW-1248-2023
dc.contributor.researcheridCNK-0895-2022
dc.contributor.researcheridGXD-8209-2022
dc.date.accessioned2024-09-09T07:50:20Z
dc.date.available2024-09-09T07:50:20Z
dc.date.issued2023-10-16
dc.description.abstractBackgroundDiagnostic accuracy of galactomannan measurements is highly variable depending on the study population, diagnostic procedures, and treatment procedures. We aimed to evaluate the effect of posaconazole prophylaxis and empiric antifungal treatment upon diagnostic accuracy of GM measurements in bronchoalveolar lavage (BAL), bronchial lavage (BL), and serum in hematological malignancy population.MethodsPatients hospitalized in a single tertiary care center with hematologic malignancies undergoing fiberoptic bronchoscopy (FOB) with a preliminary diagnosis of IPA were retrospectively included.ResultsIn all the study population (n = 327), AUC for BAL, BL, and serum GM were as follows: 0.731 [0.666-0.790], 0.869 [0.816-0.912], and 0.610 [0.540-0.676] with BL samples having the best diagnostic value. GM measurements in patients under posaconazole prophylaxis (n = 114) showed similar diagnostic performance. While specificity was similar between patients with and without posaconazole prophylaxis, sensitivity of GM measurements was lower in patients with prophylaxis. Analyses with patient classified according to antifungal treatment at the time of FOB procedure (n = 166) showed a decreased diagnostic accuracy in serum GM and BAL GM measurements related with the duration of treatment. However, BAL, BL, and serum GM measurements presented similar sensitivity and specificity in higher cut-off values in longer durations of antifungal treatment.ConclusionOur study shows that posaconazole prophylaxis and active short-term (3 days) antifungal treatment do not significantly affect overall diagnostic performance of GM measurements in bronchoalveolar lavage and bronchial lavage samples. However, using different cut-off values for patients receiving active treatment might be suggested to increase sensitivity.
dc.identifier.doi10.1007/s10096-023-04686-7
dc.identifier.endpage43
dc.identifier.issn0934-9723
dc.identifier.issue1
dc.identifier.startpage33
dc.identifier.urihttps://doi.org/10.1007/s10096-023-04686-7
dc.identifier.urihttps://link.springer.com/article/10.1007/s10096-023-04686-7
dc.identifier.urihttps://hdl.handle.net/11452/44394
dc.identifier.volume43
dc.identifier.wos001096591600001
dc.indexed.wosWOS.SCI
dc.language.isoen
dc.publisherSpringer
dc.relation.journalEuropean Journal of Clinical Microbiology & Infectious Diseases
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.subjectBronchoalveolar lavage fluid
dc.subjectInvasive pulmonary aspergillosis
dc.subjectInfectious-diseases society
dc.subjectGalactomannan enzyme-immunoassay
dc.subjectPractice guidelines
dc.subjectDiagnosis
dc.subjectManagement
dc.subjectAssay
dc.subjectSensitivity
dc.subjectKinetics
dc.subjectGalactomannan diagnostic performance
dc.subjectBronchoalveolar lavage
dc.subjectAntifungal therapy
dc.subjectInfectious diseases
dc.subjectMicrobiology
dc.titleImpact of posaconazole prophylaxis and antifungal treatment on BAL GM performance in hematology malignancy patients with febrile neutropenia: A real life experience
dc.typeArticle
dspace.entity.typePublication
local.contributor.departmentTıp Fakültesi/Göğüs Hastalıkları Ana Bilim Dalı
local.contributor.departmentTıp Fakültesi/İç Hastalıkları Ana Bilim Dalı
local.contributor.departmentTıp Fakültesi/Hematoloji Ana Bilim Dalı
local.contributor.departmentTıp Fakültesi/Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Ana Bilim Dalı
local.contributor.departmentTıp Fakültesi/Mikrobiyoloji Ana Bilim Dalı
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