title: Blood product transfusions are associated with an increase in serum (1-3)-beta-d-glucan in infants during the initial hospitalization in neonatal intensive care unit (NICU).
abstract: BACKGROUND
  Serum (1-3)-beta-d-glucan (BDG) assay has been proposed as an adjunct for the rapid diagnosis of invasive fungal infection (IFI). However, false-positive results have been reported following transfusion of blood products in adults.
  
  
  OBJECTIVE
  To assess the relationship between blood product transfusion and elevated BDG in neonates.
  
  
  METHODS
  Retrospective study including neonates ≤32 weeks, with no fungal colonization or infection, in whom BDG assay was performed for suspicion of IFI. Patients were classified in Transfusion (n = 78) and No Transfusion (n = 55) groups depending on whether or not they were transfused. Clinical, biochemical and microbiological characteristics were recorded. A BDG assay >80 pg/mL was considered as positive.
  
  
  METHODS
  bivariate and multivariate logistic regression. Results (median, IQR): One hundred and thirty-three infants were included (gestational age 28.4 weeks, 26.9-30; birth weight 1000 g, 847-1300). BDG was higher in the Transfusion group (170 pg/mL, 65-317) than in the No Transfusion group (57 pg/mL, 34-108; p < 0.001). False-positive BDG assay results were associated with red blood cells (RBC) and fresh frozen plasma (FFP) transfusions.
  
  
  CONCLUSIONS
  BDG is increased after RBC and FFP transfusions in neonates, leading to overdiagnosis of IFI. Fungal colonization status in peripheral sites and central cultures could help to reduce the risk of misdiagnosis.
authors.affiliation: a Neonatal Intensive Care Unit and.|c GRAMFC, INSERM U1105, Université De Picardie Jules Verne , Amiens , France.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Goudjil
authors.affiliation: a Neonatal Intensive Care Unit and.
authors.forename: Christèle
authors.initials: C
authors.lastname: Chazal
authors.affiliation: a Neonatal Intensive Care Unit and.
authors.forename: François
authors.initials: F
authors.lastname: Moreau
authors.affiliation: a Neonatal Intensive Care Unit and.
authors.forename: André
authors.initials: A
authors.lastname: Leke
authors.affiliation: a Neonatal Intensive Care Unit and.|c GRAMFC, INSERM U1105, Université De Picardie Jules Verne , Amiens , France.
authors.forename: Guy
authors.initials: G
authors.lastname: Kongolo
authors.affiliation: b Laboratory of Mycology and Parasitology , CHU Amiens Picardie , Amiens , France , and.
authors.forename: Tayeb
authors.initials: T
authors.lastname: Chouaki
mesh_terms: D016913:Blood Component Transfusion / Q000009:adverse effects / Q000706:statistics & numerical data; D005189:False Positive Reactions; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data; D000072742:Invasive Fungal Infections / Q000097:blood / Q000151:congenital / Q000175:diagnosis / Q000453:epidemiology; D008297:Male; D000069342:Medical Overuse / Q000706:statistics & numerical data; D012189:Retrospective Studies; D047071:beta-Glucans / Q000097:blood*
chemical_list: D047071:beta-Glucans
keywords: Beta-d-glucan; NICU; biomarker; neonatal candidiasis; neonatal infection