Evaluation of plasma (1-->3)-beta-D-glucan measurement by the kinetic turbidimetric Limulus test, for the clinical diagnosis of mycotic infections.
The present multicentre clinical study was conducted to assess the clinical utility of a new diagnostic method for deep mycosis in which (1-->3)-beta-D-glucan, a fungal cell wall component existing in plasma, was quantitatively measured by the kinetic turbidimetric Limulus test (WB003). Plasma (1-->3)-beta-D-glucan concentrations were 0.57 +/- 0.10 microgram/l in 92 healthy subjects and 0.62 +/- 0.32 microgram/l in 26 patients with non-mycotic diseases (disease control group). In comparison with these healthy subjects and patients with non-mycotic diseases, patients with mycosis had significantly higher plasma (1-->3)-beta-D-glucan concentrations: 19.63 +/- 73.28 micrograms/l in 12 patients with candidaemia, 11.28 +/- 21.42 micrograms/l in 7 patients with urinary Candida infection, 4.84 +/- 12.71 micrograms/l in 5 patients with pulmonary candidiasis, and 12.21 +/- 31.31 micrograms/l in 4 patients with invasive pulmonary aspergillosis. On the statistical analysis of these data, a cut-off value was set at 1.0 microgram/l. Using this cut-off value, 3 patients with pulmonary cryptococcosis and 4 patients (4/6) with pulmonary aspergilloma were all negative with low plasma (1-->3-beta-D-glucan levels. The test WB003 provided equivalent or higher efficiency of diagnosis of candidiasis and aspergillosis, in comparison with commercially available antigen detection kits, demonstrating its utility as a diagnostic reagent. It may also be useful in assessing therapeutic effectiveness when used periodically after treatment.
Mori
T
T
Department of Internal Medicine, Juntendo University School of Medicine, Tokyo, Japan.
Ikemoto
H
H
Matsumura
M
M
Yoshida
M
M
Inada
K
K
Endo
S
S
Ito
A
A
Watanabe
S
S
Yamaguchi
H
H
Mitsuya
M
M
Kodama
M
M
Tani
T
T
Yokota
T
T
Kobayashi
T
T
Kambayashi
J
J
Nakamura
T
T
Masaoka
T
T
Teshima
H
H
Yoshinaga
T
T
Kohno
S
S
Hara
K
K
Miyazaki
S
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001228:Aspergillosis / Q000097:blood / Q000175:diagnosis; D002177:Candidiasis / Q000097:blood / Q000175:diagnosis; D003453:Cryptococcosis / Q000097:blood / Q000175:diagnosis; D003951:Diagnostic Errors; D005069:Evaluation Studies as Topic; D005260:Female; D016469:Fungemia / Q000097:blood / Q000175:diagnosis; D005936:Glucans / Q000097:blood*; D006801:Humans; D007700:Kinetics; D008033:Limulus Test / Q000379:methods* / Q000706:statistics & numerical data; D008172:Lung Diseases, Fungal / Q000097:blood / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000097:blood* / Q000175:diagnosis*; D009391:Nephelometry and Turbidimetry / Q000379:methods / Q000706:statistics & numerical data; D013997:Time Factors; D014552:Urinary Tract Infections / Q000097:blood / Q000175:diagnosis; D047071:beta-Glucans
D005936:Glucans; D047071:beta-Glucans; C033363:beta-1,3-glucan