Beta- d -Glucan Detection as a Diagnostic Test for Invasive Aspergillosis in Immunocompromised Critically Ill Patients with Symptoms of Respiratory Infection: an Autopsy-Based Study
- 1 November 2011
- journal article
- research article
- Published by American Society for Microbiology in Journal of Clinical Microbiology
- Vol. 49 (11), 3783-3787
- https://doi.org/10.1128/jcm.00879-11
Abstract
Beta-(1,3)- d -glucan (BG) detection is an emerging tool to diagnose invasive fungal infections (IFIs). Invasive aspergillosis (IA) is the second most common IFI in immunocompromised intensive care unit (ICU) patients. We retrospectively analyzed the serum BG concentration (Fungitell; Associates of Cape Cod) in immunocompromised ICU patients with proven IA and in immunocompromised ICU patients in whom autopsy failed to show IFI. The study was performed in a 17-bed medical ICU in a 1,900-bed referral hospital. Patients at risk for IA were eligible for inclusion when at least two additional clinical signs were present. Patients with other IFIs were excluded. Fourteen patients with IA and 33 patients who had no IFI were eligible for inclusion. Serum BG levels were significantly higher in patients with IA than patients without an IFI ( P < 0.01). Using a cutoff of 140 pg/ml, the sensitivity and specificity were 85.7 and 69.7%, respectively; the positive and negative predictive values were 54.5 and 92.0%, respectively. The positive and negative likelihood ratios were 2.83 and 0.21, respectively. Although serum BG concentrations were higher in immunocompromised ICU patients with IA than in patients with the same risk factors who did not have IFI on autopsy, the moderate performance characteristics of this test limit its use as a diagnostic test for IA in this population.Keywords
This publication has 25 references indexed in Scilit:
- Prospective Survey of (1→3)-β- d -Glucan and Its Relationship to Invasive Candidiasis in the Surgical Intensive Care Unit SettingJournal of Clinical Microbiology, 2011
- Bronchoalveolar Lavage Fluid Galactomannan for the Diagnosis of Invasive Pulmonary Aspergillosis in Patients with Hematologic DiseasesClinical Infectious Diseases, 2009
- Correlation between galactomannan antigen levels in serum and neutrophil counts in haematological patients with invasive aspergillosisClinical Microbiology & Infection, 2009
- Revised Definitions of Invasive Fungal Disease from the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) Consensus GroupClinical Infectious Diseases, 2008
- Invasive pulmonary aspergillosis in patients with chronic obstructive pulmonary diseaseEuropean Respiratory Journal, 2007
- Evaluation of a (1→3)-β- d -Glucan Assay for Diagnosis of Invasive Fungal InfectionsJournal of Clinical Microbiology, 2005
- -D-Glucan as a Diagnostic Adjunct for Invasive Fungal Infections: Validation, Cutoff Development, and Performance in Patients with Acute Myelogenous Leukemia and Myelodysplastic SyndromeClinical Infectious Diseases, 2004
- False‐Positive Galactomannan PlateliaAspergillusTest Results for Patients Receiving Piperacillin‐TazobactamClinical Infectious Diseases, 2004
- Serum Glucan Levels Are Not Specific for Presence of Fungal Infections in Intensive Care Unit PatientsClinical and Vaccine Immunology, 2003
- Defining Opportunistic Invasive Fungal Infections in Immunocompromised Patients with Cancer and Hematopoietic Stem Cell Transplants: An International ConsensusClinical Infectious Diseases, 2002