Characteristics of nonculture commercialised diagnostic tests for invasive pulmonary aspergillosis
Target | Type of test (manufacturer) | Technique | Spectrum of detection | Type of sample | Cut-off |
Galactomannan | PlateliaTM Aspergillus EIA (Bio-Rad) | Immunoenzymatic sandwich assay | All Aspergillus species (specific)# | Serum, BAL | 0.5–1.0 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 assay | 1.0 (index value) | |||
(1→3)-β-d-Glucan | FungitellTM (Associates of Cape Cod) | Colorimetric assay (microplate) | All Aspergillus species (not specific)+ | Serum | 60–80 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 DNA | MycAssay AspergillusTM (Myconostica Ltd., now Microgen Bioproducts Ltd.) | Real-time PCR (18S rDNA) | Most relevant Aspergillus species | BAL, other respiratory samples, serum | NA |
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 PCR | Aspergillus 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.