Prompt initiation of antifungal therapy can make the difference between life and death for patients with invasive aspergillosis. Point-of-care diagnostics (POC; a.k.a. ‘bedside testing’) allows clinicians to begin treatment right away while awaiting confirmation by culture and histological examination.
Two companies have released affordable and simple to use POC tests for invasive aspergillosis. Both tests detect Aspergillus cell wall antigens in serum or BAL samples using a lateral flow assay (LFA), which is similar to a home pregnancy test, in around half an hour. Read a review on LFAs in invasive aspergillosis testing by Helft and Hoenigl (2017).
- · IMMY has released the sōna Aspergillus galactomannan LFA for diagnosis of invasive aspergillosis. Results are delivered in 30 minutes. IMMY already produces LFAs for the yeasts Cryptococcus neoformans/gattii and Coccidioides spp. Read the information leaflet
- · ISCA Diagnostics developed an Aspergillus LFA for diagnosis of invasive pulmonary aspergillosis that is available to purchase via OLM Diagnostics. OLM Diagnostics also produces an accompanying qPCR and galactomannan ELISA for confirming the diagnosis of aspergillosis.
Non-invasive LFAs are also on the horizon: MycoMed Technologies recently published a validation study of a POC urine dipstick. It is hoped that the 510(k) premarket submission to the FDA will happen before the end of 2018.
It is hoped that POC testing will help to reduce the global burden of deaths from invasive aspergillosis, particularly in high-risk settings where patients are immunosuppressed (transplants, cancer, HIV/AIDS) or in critical care wards where patients may deteriorate quickly.