[The diagnostic value of detecting plasma 1, 3-beta-D-glucan for invasive fungal infections].
OBJECTIVE
To evaluate the diagnostic value of the detection of plasma 1, 3-beta-D-glucan for invasive fungal infections (IFI).


METHODS
Plasma of patients with IFI, bacterial pneumonia, and oral pharyngeal fungal colonization, and healthy controls were collected from January 2005 to February 2006 in Nanjing General Hospital of Nanjing Military Command of PLA. G-test was used to measure the concentration of 1, 3-beta-D-glucan in the plasma.


RESULTS
The concentration of 1, 3-beta-D-glucan in plasma of patients with IFI [(29.5+/-11.5) ng/L] was significantly higher than that of patients with bacterial pneumonia [(13.1+/-5.2) ng/L], fungal colonization [(12.7+/-5.1) ng/L], and healthy controls [(11.7+/-3.5) ng/L], P<0.01. The concentration of 1, 3-beta-D-glucan in patients with bacterial pneumonia was not different as compared to that of patients with fungal colonization, and healthy controls, P>0.05. The concentration of 1, 3-beta-D-glucan in plasma of patients with invasive aspergillosis and invasive candidiasis were (24.7+/-5.8) ng/L and (33.3+/-11.4) ng/L, respectively, the difference being not significant, P>0.05. The concentration of 1, 3-beta-D-glucan in plasma of a patients with invasive pulmonary Cryptococcus neoformans infection and a patient with histoplasmosis were 13.6 ng/L and 25.7 ng/L, respectively. If 20 ng/L was taken as the cut-off value, the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 1, 3-beta-D-glucan were 84%, 91%, 84% and 91% respectively.


CONCLUSIONS
The concentration of 1, 3-beta-D-glucan in plasma of patients with IFI increases markedly, which indicates that the detection of 1, 3-beta-D-glucan in plasma is a useful method to diagnose IFI, but can not be used to differentiate aspergillosis from yeast fungus infection. If Fungitec-G kit is used to detect 1, 3-beta-D-glucan and 20 ng/L is used as the cut-off value, the sensitivity and specificity for IFI are high.
Lü
Pei-hua
PH
Department of Respiratory Diseases, Nanjing General Hospital of Nanjing Military Command of PLA, Nanjing 210002, China.
Zhao
Bei-lei
BL
Shi
Yi
Y
Wen
Yu-ting
YT
D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008172:Lung Diseases, Fungal / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000175:diagnosis; D011509:Proteoglycans; D012680:Sensitivity and Specificity; D055815:Young Adult; D047071:beta-Glucans / Q000097:blood*
D011509:Proteoglycans; D047071:beta-Glucans; C010770:polysaccharide-K