Serial sputum galactomannan as an adjunctive biomarker for the diagnosis of Aspergillus-related airway involvement in patients with cystic fibrosis

Serial sputum galactomannan as an adjunctive biomarker for the diagnosis of Aspergillus-related airway involvement in patients with cystic fibrosis. Download PDF Abstract Sputum galactomannan index (GMI) has been proposed as an adjunctive biomarker for diagnosing Aspergillus -related airway involvement. This study evaluated sputum GMI as a screening biomarker for Aspergillus colonization and chronic pulmonary aspergillosis (CPA) in people with cystic fibrosis (pwCF).

In this two-year multicenter prospective study, pwCF referred to the Iranian CF Foundation who provided at least two sputum samples within 6 months were enrolled. The optimal sputum GMI cut-off was determined by receiver operating characteristic (ROC) analysis. Participants were classified as negative, transient colonization (TC), persistent colonization (PC), or CPA using an operational case definition for resource-constrained settings in the absence of Aspergillus -specific IgG testing.

The diagnostic performance of sputum GMI was evaluated across these groups. Among 235 pwCF, 545 sputum specimens were analyzed for fungal culture and GMI. Overall, 13.6%, 6.8%, 41.3%, and 38.3% of participants were classified as CPA, PC, TC, and negative, respectively.

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