Comparison of diagnostic efficacy of galactomannan lateral flow assay vs enzyme immunoassay: importance of storage conditions

Introduction: Galactomannan antigen is a valuable biomarker for diagnosing invasive aspergillosis. Traditional methods, such as enzyme immunoassays (EIA), require batch sampling, whereas lateral flow assays (LFA) provide a simpler and faster diagnostic process. This study aimed to compare the diagn...

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Main Authors: Enes Erbağcı, Ayşe Ö Mete, Handan H Şahin, Yasemin Zer, İlkay Karaoğlan
Format: Article
Language:English
Published: The Journal of Infection in Developing Countries 2025-04-01
Series:Journal of Infection in Developing Countries
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Online Access:https://jidc.org/index.php/journal/article/view/20587
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author Enes Erbağcı
Ayşe Ö Mete
Handan H Şahin
Yasemin Zer
İlkay Karaoğlan
author_facet Enes Erbağcı
Ayşe Ö Mete
Handan H Şahin
Yasemin Zer
İlkay Karaoğlan
author_sort Enes Erbağcı
collection DOAJ
description Introduction: Galactomannan antigen is a valuable biomarker for diagnosing invasive aspergillosis. Traditional methods, such as enzyme immunoassays (EIA), require batch sampling, whereas lateral flow assays (LFA) provide a simpler and faster diagnostic process. This study aimed to compare the diagnostic efficacy of both testing methods. Methodology: This prospective case-control study involved 192 serum samples categorized according to the European Organization for Research and Treatment of Cancer/Mycoses Study Group (EORTC/MSG criteria). LFA were conducted following the manufacturer’s instructions, utilizing a cube reader. Receiver operating characteristic (ROC) analysis was performed to determine the optimal LFA threshold, and concordance analysis was conducted for both assays. Results: The indicated sensitivity and specificity of LFA at the recommended galactomannan index threshold (GMI ≥ 0.5) were 15.3% (9/59) and 99% (132/133), respectively. Post-ROC analysis at a threshold of 0.4 revealed an area under the curve (AUC) of 0.685, with sensitivity, specificity, positive predictive value, and negative predictive value at 18%, 99%, 91%, and 73%, respectively. Qualitative agreement between the tests, assessed using the Kappa statistic, indicated a very low degree of agreement (κ = 0.18). In contrast, quantitative agreement, evaluated through Kendall’s W-test, demonstrated a very high degree of agreement (W = 0.84). Conclusions: Despite previous literature suggesting the efficacy of LFA, our study found it unsuitable for screening due to its low sensitivity. We recommend exercising caution regarding the manufacturer's storage recommendations until further studies on sample storage conditions are conducted.
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spelling doaj-art-38419e2aed084ca78172588848a8d6a52025-08-20T02:16:03ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802025-04-01190410.3855/jidc.20587Comparison of diagnostic efficacy of galactomannan lateral flow assay vs enzyme immunoassay: importance of storage conditionsEnes Erbağcı0Ayşe Ö Mete1Handan H Şahin2Yasemin Zer3İlkay Karaoğlan4Ağrı Training and Research Hospital, İnfectious Diseases, Ağrı, TurkeyGaziantep University Faculty of Medicine, İnfectious Diseases, Gaziantep, TurkeyLiv Hospital Gaziantep, Hematology, Gaziantep, TurkeyGaziantep University Faculty of Medicine, Medical Microbiology, Gaziantep, TurkeyGaziantep University Faculty of Medicine, İnfectious Diseases, Gaziantep, Turkey Introduction: Galactomannan antigen is a valuable biomarker for diagnosing invasive aspergillosis. Traditional methods, such as enzyme immunoassays (EIA), require batch sampling, whereas lateral flow assays (LFA) provide a simpler and faster diagnostic process. This study aimed to compare the diagnostic efficacy of both testing methods. Methodology: This prospective case-control study involved 192 serum samples categorized according to the European Organization for Research and Treatment of Cancer/Mycoses Study Group (EORTC/MSG criteria). LFA were conducted following the manufacturer’s instructions, utilizing a cube reader. Receiver operating characteristic (ROC) analysis was performed to determine the optimal LFA threshold, and concordance analysis was conducted for both assays. Results: The indicated sensitivity and specificity of LFA at the recommended galactomannan index threshold (GMI ≥ 0.5) were 15.3% (9/59) and 99% (132/133), respectively. Post-ROC analysis at a threshold of 0.4 revealed an area under the curve (AUC) of 0.685, with sensitivity, specificity, positive predictive value, and negative predictive value at 18%, 99%, 91%, and 73%, respectively. Qualitative agreement between the tests, assessed using the Kappa statistic, indicated a very low degree of agreement (κ = 0.18). In contrast, quantitative agreement, evaluated through Kendall’s W-test, demonstrated a very high degree of agreement (W = 0.84). Conclusions: Despite previous literature suggesting the efficacy of LFA, our study found it unsuitable for screening due to its low sensitivity. We recommend exercising caution regarding the manufacturer's storage recommendations until further studies on sample storage conditions are conducted. https://jidc.org/index.php/journal/article/view/20587aspergillosisAspergillusdiagnosisgalactomannanserum
spellingShingle Enes Erbağcı
Ayşe Ö Mete
Handan H Şahin
Yasemin Zer
İlkay Karaoğlan
Comparison of diagnostic efficacy of galactomannan lateral flow assay vs enzyme immunoassay: importance of storage conditions
Journal of Infection in Developing Countries
aspergillosis
Aspergillus
diagnosis
galactomannan
serum
title Comparison of diagnostic efficacy of galactomannan lateral flow assay vs enzyme immunoassay: importance of storage conditions
title_full Comparison of diagnostic efficacy of galactomannan lateral flow assay vs enzyme immunoassay: importance of storage conditions
title_fullStr Comparison of diagnostic efficacy of galactomannan lateral flow assay vs enzyme immunoassay: importance of storage conditions
title_full_unstemmed Comparison of diagnostic efficacy of galactomannan lateral flow assay vs enzyme immunoassay: importance of storage conditions
title_short Comparison of diagnostic efficacy of galactomannan lateral flow assay vs enzyme immunoassay: importance of storage conditions
title_sort comparison of diagnostic efficacy of galactomannan lateral flow assay vs enzyme immunoassay importance of storage conditions
topic aspergillosis
Aspergillus
diagnosis
galactomannan
serum
url https://jidc.org/index.php/journal/article/view/20587
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AT handanhsahin comparisonofdiagnosticefficacyofgalactomannanlateralflowassayvsenzymeimmunoassayimportanceofstorageconditions
AT yaseminzer comparisonofdiagnosticefficacyofgalactomannanlateralflowassayvsenzymeimmunoassayimportanceofstorageconditions
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