Evaluation of Aspergillus-Specific Lateral-Flow Device Test Using Serum and Bronchoalveolar Lavage Fluid for Diagnosis of Chronic Pulmonary Aspergillosis

Aspergillus -specific lateral-flow device test (AspLFD) is a newly developed point-of-care diagnostic method for invasive pulmonary aspergillosis. However, evidence of the diagnostic performance of the AspLFD for chronic pulmonary aspergillosis (CPA) is limited. Therefore, we conducted a retrospective study to investigate this in comparison with the galactomannan (GM), β-D-glucan (BDG). Fifty patients with chronic pulmonary aspergillosis and 65 patients with respiratory disease control were enrolled in this study. Majority of the CPA disease entities were chronic pulmonary aspergillosis (64.0%, n=32), followed by subacute invasive pulmonary aspergillosis (20.0%, n=10), and simple pulmonary aspergilloma (16.0%, n=8). The sensitivities and specificities of AspLFD in the serum were 62.0% and 67.7%, respectively. GM (cut off index 1.54) showed a sensitivity of 22% and a specificity of 92.3%, whiles those of BDG (cut off 19.3 pg/ml) were 48% and 90.8%, respectively. In the bronchial lavage fluid, AspLFD showed a sensitivity of 66.7% and a specificity of 69.2%, whiles those of GM (cut off index 0.6) were 72.7% and 83.1%, respectively. The Aspergillus precipitating antibody had a 70% sensitivity. Unlike the Aspergillus precipitating antibody, AspLFD in serum showed similar sensitivity to non-fumigatus Aspergillus species. Patients with false positive results in AspLFD in serum were of a significantly higher age and had a high prevalence of cavitary lesions in chest computed tomography than patients with negative results in control group. Given the results in this study, the performance of AspLFD in serum was acceptable for the diagnosis of CPA as a point-of-care test.