Detection of serum galactomannan (GM) and (1,3)-β-d-glucan (BG) is considered useful for non-culture diagnosis of invasive pulmonary aspergillosis (IPA) in neutropenic patients. Only few studies evaluated these seromarkers in non-neutropenic patients suspected of having IPA. The aim of this study was to evaluate both tests together with the Aspergillus fumigatus-specific serum IgG and IgA (IgAG) test for serological IPA diagnosis in non-neutropenic patients. Sera from 87 patients suspected of having IPA were retrospectively analysed. Patients were categorised into groups of proven IPA (n = 10), putative IPA (n = 31) and non-IPA colonisation (n = 46). When the GM, BG and IgAG assays were used for patients included in the study, the sensitivity/specificity/positive predictive value (PPV)/negative predictive value (NPV) were 48.8%/91.3%/83.3%/66.7%, 82.9%/73.9%/73.9%/82.9% and 75.6%/95.7%/93.9%/81.5%, respectively. Thus, the highest specificity and PPV were confirmed for the IgAG assay. Improvements in the sensitivity and NPV were achieved by "at least one positive" analysis with the GM and BG assays, with the sensitivity/specificity/PPV/NPV values being 85.0%/69.6%/71.4%/84.2%. Nevertheless, the highest sensitivity and NPV were achieved by the "at least one positive" analysis combining the GM, BG and IgAG tests (97.6% and 96.8%, respectively). The involvement of the IgAG assay could improve IPA diagnosis in non-neutropenic patients by increasing the sensitivity and NPV when combined with the GM or BG assays. Furthermore, improvement was achieved by combining the GM, BG and IgAG assays using the "at least one positive test" strategy, especially if doubt exists.

Department of Epidemiology and Public Health Faculty of Medicine University of Ostrava Ostrava Czech Republic Department of Anesthesiology and Intensive Care Medicine University Hospital Ostrava Ostrava Czech Republic Department of Intensive Medicine Emergency Medicine and Forensic Studies University of Ostrava Ostrava Czech Republic

Department of Immunology Faculty of Medicine and Dentistry Palacky University Olomouc Olomouc Czech Republic

Department of Microbiology Faculty of Medicine and Dentistry Palacky University Olomouc Olomouc Czech Republic

Department of Microbiology Faculty of Medicine and Dentistry Palacky University Olomouc Olomouc Czech Republic Center of Health Services Institute of Public Health in Ostrava Ostrava Czech Republic Department of Epidemiology and Public Health Faculty of Medicine University of Ostrava Ostrava Czech Republic

Department of Microbiology Faculty of Medicine and Dentistry Palacky University Olomouc Olomouc Czech Republic Laboratory of Mycology Department of Parasitology Mycology and Mycobacteriology Prague Public Health Institute in Usti nad Labem Prague Czech Republic

Laboratory of Clinical Mycology Bacteriology and Mycology Institute of Public Health in Ostrava Ostrava Czech Republic

Laboratory of Clinical Mycology Bacteriology and Mycology Institute of Public Health in Ostrava Ostrava Czech Republic Department of Microbiology Faculty of Medicine and Dentistry Palacky University Olomouc Olomouc Czech Republic

Lung Department Krnov Combined Medical Facility Krnov Czech Republic

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