Diagnostic potential of (1,3)-beta-D-glucan and anti-Candida albicans germ tube antibodies for the diagnosis and therapeutic monitoring of invasive candidiasis in neutropenic adult patients.
The usefulness to diagnose and monitor invasive candidiasis (IC) using beta-glucan (BG) and antibodies against Candida albicans germ tubes (CAGT) was evaluated in a twice-weekly screening of 35 episodes in neutropenic adults at high risk. Three proven IC and three probable IC were assessed. Diagnostic levels of both markers were detected in 100% of proven IC and in 66% of probable IC. Sensitivity, specificity, positive and negative predictive values of BG and anti-CAGT antibodies detection were 83.3%, 89.6%, 62.5% and 96.3%, and 83.3%, 86.2%, 55.5%, 96.1%, respectively. False positive reactions occurred at a rate of 10.3% and 13.8% for the detection of BG and anti-CAGT antibodies, respectively. However, the patients with false positive results were different by each test. Both tests anticipated the clinical and radiological diagnosis, and the initiation of antifungal therapy in most patients. Combination of both tests improved specificity and positive predictive value to 100%.
Pazos
Carmen
C
Unidad de Micología, Departamento de Microbiología, Hospital Universitario 12 de Octubre, Avenida de Córdoba s/n, 28041 Madrid, Spain. pazos.c@terra.es
Moragues
María-Dolores
MD
Quindós
Guillermo
G
Pontón
José
J
del Palacio
Amalia
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000666:Amphotericin B / Q000627:therapeutic use; D000741:Anemia, Aplastic / Q000150:complications; D000908:Antibodies, Fungal / Q000097:blood* / Q000276:immunology; D000918:Antibody Specificity; D000935:Antifungal Agents / Q000627:therapeutic use; D000946:Antigens, Fungal / Q000276:immunology*; D002176:Candida albicans / Q000276:immunology*; D002177:Candidiasis / Q000175:diagnosis* / Q000209:etiology / Q000276:immunology; D005189:False Positive Reactions; D005260:Female; D015725:Fluconazole / Q000627:therapeutic use; D016469:Fungemia / Q000175:diagnosis* / Q000209:etiology / Q000276:immunology; D019337:Hematologic Neoplasms / Q000150:complications; D006505:Hepatitis / Q000175:diagnosis* / Q000209:etiology / Q000276:immunology / Q000382:microbiology; D006801:Humans; D008081:Liposomes / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000150:complications*; D010356:Patient Isolation; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D047071:beta-Glucans / Q000276:immunology*
D000908:Antibodies, Fungal; D000935:Antifungal Agents; D000946:Antigens, Fungal; D008081:Liposomes; D047071:beta-Glucans; C068538:liposomal amphotericin B; D000666:Amphotericin B; D015725:Fluconazole; C033363:beta-1,3-glucan