title: Accuracy of β-D-glucan for the diagnosis of Pneumocystis jirovecii pneumonia: a meta-analysis.
abstract: Pneumocystis jirovecii pneumonia (PCP) can affect various types of immunocompromised patients. We sought to evaluate the diagnostic accuracy of (1→3)-β-D-glucan (BDG) for the diagnosis of PCP. We carried out a meta-analysis of relevant studies, identified through PubMed and Scopus. Eligible studies were those that reported BDG diagnostic data in cases with documented PCP and controls with other conditions. Cases of invasive fungal infections and healthy controls were excluded. We performed a bivariate meta-analysis of sensitivity and specificity and constructed a hierarchical summary receiver operating characteristics (HSROC) curve. Fourteen studies were included in the meta-analysis. BDG data were analysed for 357 PCP cases and 1723 controls. The average (95% confidence interval) sensitivity and specificity of BDG were 94.8% (90.8-97.1%) and 86.3% (81.7-89.9%), respectively. The positive and negative likelihood ratios were 6.9 (5.1-9.3) and 0.06 (0.03-0.11), respectively. The area under the HSROC curve was 0.965 (0.945-0.978). Serum BDG shows excellent sensitivity and very good specificity in the diagnosis of PCP. Still, in clinical practice the test results should be interpreted in the context of the underlying clinical characteristics of the individual patient.
authors.affiliation: Alfa Institute of Biomedical Sciences (AIBS); Department of Medicine, Hygeia Hospital; Hellenic Center for Disease Control and Prevention, Marousi, Athens, Greece. Electronic address: m.falagas@aibs.gr.
authors.forename: D E
authors.initials: DE
authors.lastname: Karageorgopoulos
authors.affiliation: Department of Pulmonary Medicine, Huadong Hospital, School of Medicine, Fudan University, Shanghai, China.
authors.forename: J-M
authors.initials: JM
authors.lastname: Qu
authors.affiliation: Alfa Institute of Biomedical Sciences (AIBS).
authors.forename: I P
authors.initials: IP
authors.lastname: Korbila
authors.affiliation: Department of Pulmonary Medicine, Huadong Hospital, School of Medicine, Fudan University, Shanghai, China.
authors.forename: Y-G
authors.initials: YG
authors.lastname: Zhu
authors.affiliation: School of Applied Mathematical and Physical Sciences, National Technical University of Athens.
authors.forename: V A
authors.initials: VA
authors.lastname: Vasileiou
authors.affiliation: Alfa Institute of Biomedical Sciences (AIBS); Department of Medicine, Henry Dunant Hospital, Athens, Greece; Department of Medicine, Tufts University School of Medicine, Boston, MA, USA.
authors.forename: M E
authors.initials: ME
authors.lastname: Falagas
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D006801:Humans; D045363:Pneumocystis carinii / Q000302:isolation & purification* / Q000378:metabolism; D011020:Pneumonia, Pneumocystis / Q000097:blood* / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011509:Proteoglycans; D012372:ROC Curve; D012680:Sensitivity and Specificity; D047071:beta-Glucans / Q000097:blood*
chemical_list: D015415:Biomarkers; D011509:Proteoglycans; D047071:beta-Glucans; C010770:polysaccharide-K