[Diagnostic value of plasma (1, 3)-beta-D glucan assay for invasive fungal infections in patients with hematological disorders].
The invasive fungal infections (IFI) in immunocompromised patients are associated with a high mortality rate and diagnostic difficulty. Serological methods such as aspergillus galactomannan assay (GM test) and (1, 3)-beta-D glucan (BG) assay (G test) can be used as an adjunctive method for IFI diagnosis based on their characteristics of easy-operating, rapidness and high sensitivity. Compared with GM test, G test can be more widely used except for the diagnosis of aspergillosis. The purpose of this study was to investigate the value of G test in the diagnosis of IFI in patients with hematological disorders. The plasma was collected from 162 suspected IFI patients with hematological disorders in Beijing Daopei Hospital, including 85 patients after chemotherapy and 77 patients after stem cell transplantation from May 2007 to May 2008, BG level was measured with MB-80 Microbiology Kinetic Rapid Reader and the measured results together with the clinical characteristics were retrospectively analyzed. According to the European Organization for Research and Treatment of Cancer/Mycoses Study Group (EORTC/MSG) criteria, there were 2 patients diagnosed as proven IFI, 18 as probable IFI, 75 as possible IFI and 67 as no IFI. The results showed that at a cutoff of 20 pg/ml, the sensitivity and specificity of G test were 75% and 91% respectively, with a positive predictive value (PPV) of 71.4% and a negative predictive value (NPV) of 92.4%. 51 out of the 75 possible IFI patients with elevated BG level were responsive to antifungal treatment but non responsive to broad-spectrum antibiotics, retrospectively were diagnosed as IFI, suggesting that G test improved the IFI diagnostic rate by 31.4%. In conclusion, G test is a rapid and simple method for early diagnosis of IFI in patients with hematological disorders.
Liu
Fang
F
Department of Transplantation, Beijing Daopei Hospital, Beijing 10049, China.
Wu
Tong
T
Cai
Peng
P
Liu
Ying
Y
Lu
Yue
Y
Zhou
Jia-Rui
JR
Yang
Fan
F
Liu
Qiang
Q
Gao
Yan-Qun
YQ
Luo
Rong-Mu
RM
Zhang
Jian-Ping
JP
Sun
Yuan
Y
Cao
Xing-Yu
XY
Yin
Yu-Ming
YM
Zhao
Yan-Li
YL
Wang
Jing-Bo
JB
Tong
Chun-Rong
CR
Lu
Dao-Pei
DP
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D006402:Hematologic Diseases / Q000097:blood / Q000175:diagnosis* / Q000382:microbiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000097:blood / Q000175:diagnosis*; D010949:Plasma / Q000737:chemistry; D055815:Young Adult; D047071:beta-Glucans / Q000097:blood*
D047071:beta-Glucans