The Aspergillus Lateral Flow Assay for the Diagnosis of Invasive Aspergillosis: an Update
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ADVANCES IN DIAGNOSIS OF INVASIVE FUNGAL INFECTIONS (O MORRISSEY, SECTION EDITOR)
The Aspergillus Lateral Flow Assay for the Diagnosis of Invasive Aspergillosis: an Update Jeffrey D. Jenks 1,2,3
&
Marisa H. Miceli 4 & Juergen Prattes 5 & Toine Mercier 6,7 & Martin Hoenigl 2,3,8
Accepted: 20 October 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review To review the data on the Aspergillus lateral flow assay for the diagnosis of invasive Aspergillosis. Recent Findings Aspergillus spp. cause a wide spectrum of disease with invasive aspergillosis (IA) as its most severe manifestation. Early and reliable diagnosis of disease is crucial to decrease associated morbidity and mortality, and enable prompt initiation of treatment for IA. Most recently, non-culture-based tests, such as Aspergillus galactomannan (GM), have been useful in early identification and treatment of patients with IA. However, cost, turnaround time, and variable performance indifferent populations at risk for IA remain significant drawbacks to the use of this test. Several diagnostic tests for IA have been developed, including the sōna Aspergillus GM Lateral flow assay (GM-LFA) rapid test. Summary The GM-LFA has shown excellent performance for the diagnosis of IA in patients with hematologic malignancy and may be a viable option for settings where ELISA GM testing is not feasible. Further evaluation of the GM-LFA in the nonhematology setting is ongoing, including in solid organ transplant recipients and patients in the intensive care unit. Keywords Lateral flow assay . Bronchoalveolar lavage . Serum . Urine . Digital reader
Introduction Aspergillus spp. are environmental fungi that cause a wide spectrum of infections in humans [1], including invasive aspergillosis (IA), the most severe manifestation of disease. Globally, IA causes over 300,000 diagnosed infections annually, with a mortality rate ranging from 30 to 80% [2, 3].
Recently, IA also emerged as a complication in patients with severe Coronavirus Disease 2019, resulting in high mortality rates [4–7]. Diagnosis of IA remains difficult, particularly in patients receiving mold-active antifungals [8, 9]. Aspergillus galactomannan (GM) is an enzyme-linked immunosorbent assay (ELISA) which detects the GM polysaccharide that
This article is part of the Topical Collection on Advances in Diagnosis of Invasive Fungal Infections * Jeffrey D. Jenks [email protected] 1
2
3
Division of General Internal Medicine, University of California San Diego, La Jolla, CA, USA Division of Infectious Diseases and Global Health, University of California San Diego, La Jolla, CA, USA Clinical and Translational Fungal-Working Group, University of California San Diego, La Jolla, CA, USA
4
Division of Infectious Diseases, Department of Medicine, University of Michigan, Ann Arbor, MI, USA
5
Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, Graz, Austria
6
Department of Hematology, University Hospitals L
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