(1-3)-β-D-glucan levels in candidiasis infections in the critically ill neonate.
BACKGROUND
The diagnosis of neonatal invasive Candida infections (ICIs) is problematic because the clinical signs are not specific and blood cultures are rarely positive. Hence, new diagnostic markers are needed.


OBJECTIVE
To assess the contribution of serum (1-3)-β-d-glucan (BDG) levels to the diagnosis of neonatal ICIs and to analyse the change in this parameter during antifungal therapy.


METHODS
This retrospective study (December 2010-March 2012) was performed at Amiens University Medical Center (Amiens, France). We included newborns in whom a BDG assay was performed for a suspected ICI and classified as infected (n = 18) or non-infected (n = 43).


RESULTS
Sixty-one patients (median (IQR) gestational age: 28.5 weeks (26.7-30.6); birth weight: 1000 g (910-1440)) were included. The BDG level was higher in the infected group (364 pg/ml (131-976) vs. 89 pg/ml (30-127); p < 0.001). The optimal BDG cut-off for distinguishing between non-infected and infected patients was 125 pg/ml (Se = 84%, Sp = 75%). The BDG level fell over the course of antifungal therapy.


CONCLUSIONS
Our study results suggest that BDG levels were increased in neonatal invasive Candida infections (cut-off for BDG positivity > 125 pg/ml). The change in the serum BDG levels may be of value in evaluating the efficacy of antifungal therapy.
Department of Pediatrics, Amiens University Medical Center, Amiens, France. goudsab2002@yahoo.fr
Sabrina
S
Goudjil
Guy
G
Kongolo
Lucie
L
Dusol
Fatiha
F
Imestouren
Marjorie
M
Cornu
Andre
A
Leke
Taieb
T
Chouaki
D000935:Antifungal Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000382:microbiology; D015415:Biomarkers / Q000097:blood; D002177:Candidiasis / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000097:blood; D007235:Infant, Premature, Diseases / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy; D008297:Male; D011247:Pregnancy; D011509:Proteoglycans; D012189:Retrospective Studies; D047071:beta-Glucans / Q000097:blood*
D000935:Antifungal Agents; D015415:Biomarkers; D011509:Proteoglycans; D047071:beta-Glucans; C010770:polysaccharide-K