Performance of the Urinary MycoMEIA Aspergillus Assay as an Aid to Diagnose Invasive Aspergillosis
In brief
Urine Aspergillus assay detected 92% of invasive cases in study
In testing that included 50 invasive aspergillosis cases and 240 controls, the urine assay had 92% sensitivity and 87.6% specificity. It also detected 19 of 24 cases that were positive on lung sampling but negative on a blood test, suggesting it could add diagnostic value without invasive sampling; cross-reactions and performance in broader populations still need study.
- Journal
- Clinical infectious diseases : an official publication of the Infectious Diseases Society of America (Q1)
- Published
- 7 October 2026
- Study design
- Prospective / inception cohort
- Evidence level
- Level 2, Moderate (CEBM 2b)
- Authors
- Irina Baburina, Kieren A Marr, Yuri Vanbiervliet, Nitipong Permpalung, Chiung-Yu Huang, Robina Aerts, et al.
- PMID
- 42841776
- DOI
- 10.1093/cid/ciag522
Why clinicians should know about it
- Picked for Microbiology (medical) (paper of the day, 8 October 2026): Urinary Aspergillus assay performance for IA diagnosis
Abstract
BACKGROUND: Invasive aspergillosis (IA) is difficult to diagnose, contributing to poor clinical outcomes and unnecessary antifungal therapies. The MycoMEIA Aspergillus assay (MycoMEIA), which detects Aspergillus glycans in urine, does not require invasive specimens. We report data that supported regulatory approval. METHODS: A case-control study and prospective cohort study were conducted to evaluate MycoMEIA as an aid to diagnose IA. Performance was assessed using consensus criteria of "proven" or "probable" IA and controls. Additional analyses evaluated positivity in "possible" IA, agreement with serum galactomannan (GM EIA), cross-reactivity, and timing of positivity relative to clinical diagnosis. Reproducibility was assessed across three laboratories. RESULTS: In brief, 469 urine samples from 50 IA cases and 240 controls demonstrated MycoMEIA 92% (95% CI 80.8-97.8) sensitivity and 87.6% (95% CI 82.8-91.8) specificity. All cases with positive serum GM EIA were positive by MycoMEIA. Urine testing identified 19/24 (79.2%) IA cases diagnosed by bronchoalveolar lavage (BAL) but negative by serum GM EIA and provided lead-time positivity of 5 days (range -21 to +14) before clinical diagnosis. Prospective testing confirmed a specificity of 89.7% (95% CI 75.8-97.1) and identified IA in 28/102 (27.5%) people with suspected "possible" IA. Some cross-reactivity was observed with other Ascomycetes fungi. Results were reproducible across sites. CONCLUSIONS: MycoMEIA shows strong performance as an aid to diagnose IA. Its high sensitivity and negative predictive value may help reduce unnecessary empirical antifungals. Further studies are needed to define its role in screening and broader patient populations.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.