title: Reactivity of (1→3)-β-d-glucan assay in bacterial bloodstream infections.
abstract: To diagnose invasive fungal infections, the detection of (1 → 3)-β-d-glucan in serum has shown variable specificity, depending on the targeted population. Several circumstances for false-positive results of beta-glucan tests have been identified, among which are severe bacterial infections. In this study, we measured (1 → 3)-β-d-glucan by the Fungitell test in the serum of 62 patients (one serum sample tested per patient) for whom invasive fungal infection was not suspected: 19 control subjects and 43 patients with bacteraemia. The test was interpretable for 58 sera: all 19 control subjects had negative beta-glucan test; among the 39 bacteraemic patients, we report 16 false-positive results. For the 22 patients undergoing bacteraemia due to Gram-negative bacilli, we observed 13 false-positive results (59%). Among the 17 patients with bloodstream infection involving Gram-positive cocci, three false-positive tests were recorded, but none in the eight cases of Streptococcus pneumoniae bacteraemia. Statistical analysis showed that beta-glucan levels were significantly higher in patients with Gram-negative bacilli bloodstream infection in comparison to those with bacteraemia due to Gram-positive cocci. These results were independent from other previously described causes for false-positive beta-glucan tests. These data might help physicians to interpret positive beta-glucan detection when an invasive fungal infection is suspected, especially for patients with bacterial infections.
authors.affiliation: Laboratoire de Parasitologie Mycologie, CHU de Reims, Université Reims Champagne Ardenne, Hôpital Maison Blanche, 45 rue Cognacq Jay, 51092 Reims cedex, France. oalbert@chu-reims.fr
authors.forename: O
authors.initials: O
authors.lastname: Albert
authors.forename: D
authors.initials: D
authors.lastname: Toubas
authors.forename: C
authors.initials: C
authors.lastname: Strady
authors.forename: J
authors.initials: J
authors.lastname: Cousson
authors.forename: C
authors.initials: C
authors.lastname: Delmas
authors.forename: V
authors.initials: V
authors.lastname: Vernet
authors.forename: I
authors.initials: I
authors.lastname: Villena
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000175:diagnosis* / Q000382:microbiology; D002675:Child, Preschool; D005189:False Positive Reactions; D005260:Female; D005602:France; D006090:Gram-Negative Bacteria / Q000302:isolation & purification*; D006094:Gram-Positive Bacteria / Q000302:isolation & purification*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011509:Proteoglycans; D011933:Reagent Kits, Diagnostic; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013997:Time Factors; D055815:Young Adult; D047071:beta-Glucans / Q000097:blood*
chemical_list: D011509:Proteoglycans; D011933:Reagent Kits, Diagnostic; D047071:beta-Glucans; C010770:polysaccharide-K