A pilot study on nasal wash galactomannan as a surrogate marker for invasive aspergillosis among hematology patients in Thailand
Abstract Universal antifungal treatment has been recommended among hematology patients during chemotherapy to prevent invasive aspergillosis (IA) in developed countries, but it remains a significant challenge in resource-limited settings. Identifying at-risk individuals could enhance clinical outcom...
Saved in:
| Main Authors: | , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2024-11-01
|
| Series: | Scientific Reports |
| Subjects: | |
| Online Access: | https://doi.org/10.1038/s41598-024-80374-6 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1846147837034758144 |
|---|---|
| author | Natnai Charoonrochana Natini Jinawath Pitak Santanirand Atisak Jiaranaikulwanich Aruchalean Taweewongsounton Chavachol Setthaudom Tananun Tanpaibule Dootsadeephorn Surin Pansachee Damronglerd Wasithep Limvorapitak Sirapat Rungwittayatiwat Subencha Pinsai Pimjai Niparuck Porpon Rotjanapan |
| author_facet | Natnai Charoonrochana Natini Jinawath Pitak Santanirand Atisak Jiaranaikulwanich Aruchalean Taweewongsounton Chavachol Setthaudom Tananun Tanpaibule Dootsadeephorn Surin Pansachee Damronglerd Wasithep Limvorapitak Sirapat Rungwittayatiwat Subencha Pinsai Pimjai Niparuck Porpon Rotjanapan |
| author_sort | Natnai Charoonrochana |
| collection | DOAJ |
| description | Abstract Universal antifungal treatment has been recommended among hematology patients during chemotherapy to prevent invasive aspergillosis (IA) in developed countries, but it remains a significant challenge in resource-limited settings. Identifying at-risk individuals could enhance clinical outcomes. A prospective pilot study was conducted at four Thai tertiary care hospitals from April 2021 to January 2023, aiming to assess the correlation and the potential of nasal wash galactomannan (GM) as an IA predictor in hematology patients. It enrolled all patients with acute myeloid leukemia (AML) requiring induction chemotherapy and those admitted for stem cell transplantation (SCT). Nasal wash fluid samples were collected for galactomannan testing and fungal culture to assess Aspergillus spp. colonization before chemotherapy. The study included 34 AML and SCT patients. Among them, 3/34 tested positive for Aspergillus spp. colonization via nasal wash fungal culture. After six months, 18 (52.9%) patients were diagnosed with IA—15/25 patients with AML and 3/9 SCT recipients. The traditional culture did not predict IA, whereas nasal wash fluid galactomannan cutoff value of 0.46 yielded a sensitivity of 40% and a specificity of 80% for predicting probable and possible IA in patients with AML. However, in the subgroup analysis, the test did not reveal any correlation with IA development. More extensive studies are needed to validate the optimal IA risk prediction strategy. |
| format | Article |
| id | doaj-art-b8e609fb32f442e99a9c9dd2e8c4bb65 |
| institution | Kabale University |
| issn | 2045-2322 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj-art-b8e609fb32f442e99a9c9dd2e8c4bb652024-12-01T12:25:15ZengNature PortfolioScientific Reports2045-23222024-11-0114111310.1038/s41598-024-80374-6A pilot study on nasal wash galactomannan as a surrogate marker for invasive aspergillosis among hematology patients in ThailandNatnai Charoonrochana0Natini Jinawath1Pitak Santanirand2Atisak Jiaranaikulwanich3Aruchalean Taweewongsounton4Chavachol Setthaudom5Tananun Tanpaibule6Dootsadeephorn Surin7Pansachee Damronglerd8Wasithep Limvorapitak9Sirapat Rungwittayatiwat10Subencha Pinsai11Pimjai Niparuck12Porpon Rotjanapan13Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol UniversityProgram in Translational Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol UniversityDivision of Clinical Microbiology, Department of Pathology, Faculty of Medicine Ramathibodi Hospital, Mahidol UniversityDivision of Clinical Microbiology, Department of Pathology, Faculty of Medicine Ramathibodi Hospital, Mahidol UniversityResearch Center, Faculty of Medicine Ramathibodi Hospital, Mahidol UniversityDivision of Immunology, Department of Pathology, Faculty of Medicine, Ramathibodi HospitalDepartment of Medicine, Faculty of Medicine Vajira Hospital, Navamindradhiraj UniversityDepartment of Medicine, Faculty of Medicine Vajira Hospital, Navamindradhiraj UniversityDivision of Infectious Diseases, Department of Medicine, Faculty of Medicine, Thammasat UniversityDivision of Hematology, Department of Medicine, Faculty of Medicine, Thammasat UniversityDepartment of Medicine, Chao Phraya Abhaibhubejhr HospitalDepartment of Medicine, Chao Phraya Abhaibhubejhr HospitalDivision of Hematology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol UniversityDivision of Infectious Diseases, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol UniversityAbstract Universal antifungal treatment has been recommended among hematology patients during chemotherapy to prevent invasive aspergillosis (IA) in developed countries, but it remains a significant challenge in resource-limited settings. Identifying at-risk individuals could enhance clinical outcomes. A prospective pilot study was conducted at four Thai tertiary care hospitals from April 2021 to January 2023, aiming to assess the correlation and the potential of nasal wash galactomannan (GM) as an IA predictor in hematology patients. It enrolled all patients with acute myeloid leukemia (AML) requiring induction chemotherapy and those admitted for stem cell transplantation (SCT). Nasal wash fluid samples were collected for galactomannan testing and fungal culture to assess Aspergillus spp. colonization before chemotherapy. The study included 34 AML and SCT patients. Among them, 3/34 tested positive for Aspergillus spp. colonization via nasal wash fungal culture. After six months, 18 (52.9%) patients were diagnosed with IA—15/25 patients with AML and 3/9 SCT recipients. The traditional culture did not predict IA, whereas nasal wash fluid galactomannan cutoff value of 0.46 yielded a sensitivity of 40% and a specificity of 80% for predicting probable and possible IA in patients with AML. However, in the subgroup analysis, the test did not reveal any correlation with IA development. More extensive studies are needed to validate the optimal IA risk prediction strategy.https://doi.org/10.1038/s41598-024-80374-6GalactomannanNasal washInvasive aspergillosisAcute myeloid leukemiaHematopoietic stem cell transplant |
| spellingShingle | Natnai Charoonrochana Natini Jinawath Pitak Santanirand Atisak Jiaranaikulwanich Aruchalean Taweewongsounton Chavachol Setthaudom Tananun Tanpaibule Dootsadeephorn Surin Pansachee Damronglerd Wasithep Limvorapitak Sirapat Rungwittayatiwat Subencha Pinsai Pimjai Niparuck Porpon Rotjanapan A pilot study on nasal wash galactomannan as a surrogate marker for invasive aspergillosis among hematology patients in Thailand Scientific Reports Galactomannan Nasal wash Invasive aspergillosis Acute myeloid leukemia Hematopoietic stem cell transplant |
| title | A pilot study on nasal wash galactomannan as a surrogate marker for invasive aspergillosis among hematology patients in Thailand |
| title_full | A pilot study on nasal wash galactomannan as a surrogate marker for invasive aspergillosis among hematology patients in Thailand |
| title_fullStr | A pilot study on nasal wash galactomannan as a surrogate marker for invasive aspergillosis among hematology patients in Thailand |
| title_full_unstemmed | A pilot study on nasal wash galactomannan as a surrogate marker for invasive aspergillosis among hematology patients in Thailand |
| title_short | A pilot study on nasal wash galactomannan as a surrogate marker for invasive aspergillosis among hematology patients in Thailand |
| title_sort | pilot study on nasal wash galactomannan as a surrogate marker for invasive aspergillosis among hematology patients in thailand |
| topic | Galactomannan Nasal wash Invasive aspergillosis Acute myeloid leukemia Hematopoietic stem cell transplant |
| url | https://doi.org/10.1038/s41598-024-80374-6 |
| work_keys_str_mv | AT natnaicharoonrochana apilotstudyonnasalwashgalactomannanasasurrogatemarkerforinvasiveaspergillosisamonghematologypatientsinthailand AT natinijinawath apilotstudyonnasalwashgalactomannanasasurrogatemarkerforinvasiveaspergillosisamonghematologypatientsinthailand AT pitaksantanirand apilotstudyonnasalwashgalactomannanasasurrogatemarkerforinvasiveaspergillosisamonghematologypatientsinthailand AT atisakjiaranaikulwanich apilotstudyonnasalwashgalactomannanasasurrogatemarkerforinvasiveaspergillosisamonghematologypatientsinthailand AT aruchaleantaweewongsounton apilotstudyonnasalwashgalactomannanasasurrogatemarkerforinvasiveaspergillosisamonghematologypatientsinthailand AT chavacholsetthaudom apilotstudyonnasalwashgalactomannanasasurrogatemarkerforinvasiveaspergillosisamonghematologypatientsinthailand AT tananuntanpaibule apilotstudyonnasalwashgalactomannanasasurrogatemarkerforinvasiveaspergillosisamonghematologypatientsinthailand AT dootsadeephornsurin apilotstudyonnasalwashgalactomannanasasurrogatemarkerforinvasiveaspergillosisamonghematologypatientsinthailand AT pansacheedamronglerd apilotstudyonnasalwashgalactomannanasasurrogatemarkerforinvasiveaspergillosisamonghematologypatientsinthailand AT wasitheplimvorapitak apilotstudyonnasalwashgalactomannanasasurrogatemarkerforinvasiveaspergillosisamonghematologypatientsinthailand AT sirapatrungwittayatiwat apilotstudyonnasalwashgalactomannanasasurrogatemarkerforinvasiveaspergillosisamonghematologypatientsinthailand AT subenchapinsai apilotstudyonnasalwashgalactomannanasasurrogatemarkerforinvasiveaspergillosisamonghematologypatientsinthailand AT pimjainiparuck apilotstudyonnasalwashgalactomannanasasurrogatemarkerforinvasiveaspergillosisamonghematologypatientsinthailand AT porponrotjanapan apilotstudyonnasalwashgalactomannanasasurrogatemarkerforinvasiveaspergillosisamonghematologypatientsinthailand AT natnaicharoonrochana pilotstudyonnasalwashgalactomannanasasurrogatemarkerforinvasiveaspergillosisamonghematologypatientsinthailand AT natinijinawath pilotstudyonnasalwashgalactomannanasasurrogatemarkerforinvasiveaspergillosisamonghematologypatientsinthailand AT pitaksantanirand pilotstudyonnasalwashgalactomannanasasurrogatemarkerforinvasiveaspergillosisamonghematologypatientsinthailand AT atisakjiaranaikulwanich pilotstudyonnasalwashgalactomannanasasurrogatemarkerforinvasiveaspergillosisamonghematologypatientsinthailand AT aruchaleantaweewongsounton pilotstudyonnasalwashgalactomannanasasurrogatemarkerforinvasiveaspergillosisamonghematologypatientsinthailand AT chavacholsetthaudom pilotstudyonnasalwashgalactomannanasasurrogatemarkerforinvasiveaspergillosisamonghematologypatientsinthailand AT tananuntanpaibule pilotstudyonnasalwashgalactomannanasasurrogatemarkerforinvasiveaspergillosisamonghematologypatientsinthailand AT dootsadeephornsurin pilotstudyonnasalwashgalactomannanasasurrogatemarkerforinvasiveaspergillosisamonghematologypatientsinthailand AT pansacheedamronglerd pilotstudyonnasalwashgalactomannanasasurrogatemarkerforinvasiveaspergillosisamonghematologypatientsinthailand AT wasitheplimvorapitak pilotstudyonnasalwashgalactomannanasasurrogatemarkerforinvasiveaspergillosisamonghematologypatientsinthailand AT sirapatrungwittayatiwat pilotstudyonnasalwashgalactomannanasasurrogatemarkerforinvasiveaspergillosisamonghematologypatientsinthailand AT subenchapinsai pilotstudyonnasalwashgalactomannanasasurrogatemarkerforinvasiveaspergillosisamonghematologypatientsinthailand AT pimjainiparuck pilotstudyonnasalwashgalactomannanasasurrogatemarkerforinvasiveaspergillosisamonghematologypatientsinthailand AT porponrotjanapan pilotstudyonnasalwashgalactomannanasasurrogatemarkerforinvasiveaspergillosisamonghematologypatientsinthailand |