title: Early serum (1→3)-β-D-glucan levels in patients with burn injury.
abstract: Serum (1→3)-β-D-glucan (BG) is increasingly used as diagnostic marker for invasive fungal infections. Exposure to gauze may lead to false-positive BG assays. The role of BG is unclear in thermally injured patients who frequently require extensive gauze coverage; therefore, we prospectively evaluated BG levels in burn-injured patients. Serum BG levels were measured in 18 burn patients immediately before application of the first dressing and 12 h after. Patients were stratified by extent of total body surface area (TBSA) requiring gauze coverage: <20%, 20-39%, 40-60% and >60%. BG levels were obtained from patients with non-burn trauma as controls. BG results were positive (>80 pg ml⁻¹) in 9/18 (50%) patients at baseline and in 8/18 (44%) 12 h after application of the first dressing. BG levels were positive in 1/5 (20%) of patients with <20% TBSA requiring gauze and in 10/13 (77%) with ≥ 20% (P < 0.05). None of the control patients had positive BG at any time point and none of the patients had candidemia at baseline. Mean serum BG levels decreased (19.44 pg ml⁻¹) after gauze placement. False-positive serum BG elevations are common in this patient population. Positivity correlates with extent of TBSA injured, but is not impacted by the gauze itself.
authors.affiliation: The Burn Center, Department of Surgery, Washington Hospital Center, Washington, DC 20010, USA. jeffrey.w.shupp@medstar.net
authors.forename: Jeffrey W
authors.initials: JW
authors.lastname: Shupp
authors.forename: Ruta
authors.initials: R
authors.lastname: Petraitiene
authors.forename: Amin D
authors.initials: AD
authors.lastname: Jaskille
authors.forename: Anna R
authors.initials: AR
authors.lastname: Pavlovich
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Matt
authors.forename: Do T
authors.initials: do T
authors.lastname: Nguyen
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Kath
authors.forename: James C
authors.initials: JC
authors.lastname: Jeng
authors.forename: Marion H
authors.initials: MH
authors.lastname: Jordan
authors.forename: Malcolm
authors.initials: M
authors.lastname: Finkelman
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Walsh
authors.forename: Shmuel
authors.initials: S
authors.lastname: Shoham
mesh_terms: D002056:Burns / Q000097:blood / Q000150:complications*; D002175:Candida / Q000302:isolation & purification / Q000502:physiology; D058387:Candidemia / Q000097:blood* / Q000175:diagnosis / Q000209:etiology / Q000382:microbiology; D005260:Female; D006801:Humans; D011446:Prospective Studies; D011509:Proteoglycans; D047071:beta-Glucans / Q000097:blood*
chemical_list: D011509:Proteoglycans; D047071:beta-Glucans; C010770:polysaccharide-K