Beta-D-glucan as a diagnostic adjunct for invasive fungal infections: validation, cutoff development, and performance in patients with acute myelogenous leukemia and myelodysplastic syndrome.
The Glucatell (1-->3)- beta-D-glucan (BG) detection assay (Associates of Cape Cod) was studied as a diagnostic adjunct for invasive fungal infections (IFIs). On the basis of findings from a preliminary study of 30 candidemic subjects and 30 healthy adults, a serum BG level of >or=60 pg/mL was chosen as the cutoff. Testing was performed with serial serum samples obtained from 283 subjects with acute myeloid leukemia or myelodysplastic syndrome who were receiving antifungal prophylaxis. At least 1 serum sample was positive for BG at a median of 10 days before the clinical diagnosis in 100% of subjects with a proven or probable IFI. IFIs included candidiasis, fusariosis, trichosporonosis, and aspergillosis. Absence of a positive BG finding had a 100% negative predictive value, and the specificity of the test was 90% for a single positive test result and >or=96% for >or=2 sequential positive results. The Glucatell serum BG detection assay is highly sensitive and specific as a diagnostic adjunct for IFI.
Laboratory of Medical Mycology, University of Texas-Houston Medical School, Houston, TX, USA.
Zekaver
Z
Odabasi
Gloria
G
Mattiuzzi
Elihu
E
Estey
Hagop
H
Kantarjian
Fumihiro
F
Saeki
Richard J
RJ
Ridge
Paul A
PA
Ketchum
Malcolm A
MA
Finkelman
John H
JH
Rex
Luis
L
Ostrosky-Zeichner
D000328:Adult; D002177:Candidiasis / Q000097:blood; D016469:Fungemia / Q000097:blood; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000097:blood / Q000150:complications*; D008033:Limulus Test; D009181:Mycoses / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D009190:Myelodysplastic Syndromes / Q000097:blood / Q000150:complications*; D009503:Neutropenia / Q000097:blood / Q000150:complications; D011134:Polysaccharides / Q000097:blood; D011237:Predictive Value of Tests; D011509:Proteoglycans; D011933:Reagent Kits, Diagnostic; D012680:Sensitivity and Specificity; D047071:beta-Glucans / Q000097:blood*
D011134:Polysaccharides; D011509:Proteoglycans; D011933:Reagent Kits, Diagnostic; D047071:beta-Glucans; C010770:polysaccharide-K