Invasive Aspergillosis in Pediatric Hematology Oncology Ward

Background: Patients with prolonged neutropenia and/or severe underlying immunosuppression are at the greatest risk for disseminated aspergillosis. This study was undertaken to determine the incidence of invasive aspergillosis by Platelia Aspergillus enzyme-linked immunosorbent assay ELISA kit in high risk children admitted to the hematology ward of Dr. Faghihi hospital, Shiraz University of Medical Sciences, Iran. Materials and Methods: From Oct. 2006 to Jun. 2008, 62 patients with hematologic malignancies were followed and evaluated for invasive aspergillosis in Shiraz. All clinical samples were cultured and a direct microscopic examination was performed. Blood samples were cultured by bedside inoculation to BACTEC medium. Blood samples were collected prospectively once a week and stored at –20 ˚C until examination. All the collected blood samples were assayed for galactomannan antigen using Platelia Aspergillus ELISA kit. Patients were classified according to the diagnostic criteria set by the European Organization for Research and Treatment of Cancer-Mycosis Study Group. Results: The female-to-male ratio was 22:40, and mean age of the patients was 9.3 years. The sensitivity, specificity,negative and positive predictive values of the ELISA method were 91% , 90%, 83.3%, and 94.7%, respectively. Galactomannan antigen test was positive in 1 proven, 8 probable, and 2 possible cases. The incidence rate of invasive aspergillosis was found to be 16.7%. Conclusion: Considering the incidence of invasive aspergillosis and the corresponding morbidity and mortality rates in patients with hematologic disorders, it seems that more efficient methods are in demand for early diagnosis andthereby promoting the patients’ survival.