Characteristics of nonculture commercialised diagnostic tests for invasive pulmonary aspergillosis

TargetType of test (manufacturer)TechniqueSpectrum of detectionType of sampleCut-off
GalactomannanPlateliaTM Aspergillus EIA (Bio-Rad)Immunoenzymatic sandwich assayAll Aspergillus species (specific)#Serum, BAL0.5–1.0 ODI
Soña Aspergillus galactomannan LFA (IMMY)Immunochromatographic assay (LFA)Visual reading or cube reader: 0.5–1.0 (index values)
Aspergillus galactomannan VirCliaTM (Vircell)Chemoluminescent assay1.0 (index value)
(1→3)-β-d-GlucanFungitellTM (Associates of Cape Cod)Colorimetric assay (microplate)All Aspergillus species (not specific)+Serum60–80 pg·mL−1§
Fungitell STATTM (Associates of Cape Cod)Colorimetric assay (single tube)0.75–1.2 (index values)§
Wako β-glucan test (Fujifilm Wako Chemicals)Turbidimetric assay (single tube)7.0 pg·mL−1
Dynamiker Fungus (1–3)- β-d-glucan (Dynamiker Biotechnology)Colorimetric assay (microplate)70–95 pg·mL−1§
Aspergillus DNAMycAssay AspergillusTM (Myconostica Ltd., now Microgen Bioproducts Ltd.)Real-time PCR (18S rDNA)Most relevant Aspergillus speciesBAL, other respiratory samples, serumNA
AsperGeniusTM (PathoNostics)Multiplex real-time PCR (28S rDNA and Cyp51A)Most relevant Aspergillus species, Cyp51A mutations (L98H, TR34, T289A, Y121F)NA
MycoGenieTM (AdemTech)Real-time PCR (28S rDNA and Cyp51A)Aspergillus fumigatus, Cyp51A mutations (L98H, TR34)NA
Fungiplex Aspergillus azole-RTM (Bruker Daltonics GmbH)Multiplex real-time PCRAspergillus species, Cyp51A (TR34, TR46)NA

Note: the table is limited to the most relevant currently available test methods. BAL: bronchoalveolar lavage; EIA: enzyme immunoassay; LFA: lateral flow assay; NA: not applicable; ODI: optical density index. #Cross-reaction with some other fungal pathogens, e.g. Fusarium, Histoplasma. ODI 0.5 is recommended by the manufacturer. Higher cut-offs (e.g. 1.0) are recommended for better specificity, notably in non-serum samples (BAL, cerebrospinal fluid). +Detection of most other fungal pathogens with some exception (e.g. Mucorales). §Values below, within and above this range are considered as negative, indeterminate and positive, respectively.