title: Detection of β-D-glucan for the diagnosis of invasive fungal infection in children with hematological malignancy.
abstract: The ß-D-glucan assay (BDG) has been added to the EORTC/MSG criteria for the diagnosis of invasive fungal infections (IFI), but data from pediatric populations is scarce. The aim of this study was to evaluate performance of BDG in a cohort of hemato-oncological children with hematological malignancy at risk for IFI.
  
  
  
  113 patients were included through an 18-month period. In addition to routine IFI screening, BDG was assayed once a week. IFIs were classified using EORTC/MSG criteria without including the BDG results. Performances were assessed after a ROC analysis for optimization and multivariate analysis to detect the causes of false positivity.
  
  
  
  8 proven and 4 probable IFIs, and 7 possible IFIs were diagnosed in 9 and 7 patients, respectively. Sensitivity and specificity increased from 75% and 56% to 100% and 91.1%, respectively when considering the whole population and patients not having received any antifungals prior to the test. Multivariate analysis revealed that being younger than 7, severe colitis/mucositis, recent administration of polyvalent immunoglobulins and digestive colonization with Enterococcus sp were independent risk factors for false positivity.
  
  
  
  BDG is a valuable test to detect IFI in pediatric patients not previously treated with antifungals and to detect the occurrence of chronic infection.
authors.affiliation: AP-HP, Hôpital St Antoine, Service de Parasitologie-Mycologie, 34 rue Crozatier, F-75012 Paris, France; Sorbonne Universités, UPMC Univ Paris 06, Inserm UMR S 1135, CNRS ERL 8255, Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), 91 Bd de l'hôpital, F-75013 Paris, France. Electronic address: juliette.guitard@gmail.com.
authors.forename: Juliette
authors.initials: J
authors.lastname: Guitard
authors.affiliation: AP-HP, Hôpital Trousseau-La Roche Guyon, Service d'Hématologie-oncologie pédiatrique, 26 av. du Docteur Arnold-Netter, 75012 Paris, France. Electronic address: marie-dominique.tabone@aphp.fr.
authors.forename: Marie-Dominique
authors.initials: MD
authors.lastname: Tabone
authors.affiliation: AP-HP, Hôpital St Antoine, Service de Parasitologie-Mycologie, 34 rue Crozatier, F-75012 Paris, France. Electronic address: yaye.senghor@aphp.fr.
authors.forename: Yaye
authors.initials: Y
authors.lastname: Senghor
authors.affiliation: AP-HP, Hôpital Trousseau-La Roche Guyon, Service de Pharmacie, 26 av. du Docteur Arnold-Netter, 75012 Paris, France. Electronic address: cyrille.cros@aphp.fr.
authors.forename: Cyrille
authors.initials: C
authors.lastname: Cros
authors.affiliation: AP-HP, Hôpital Trousseau-La Roche Guyon, Service de Bactériologie, 26 av. du Docteur Arnold-Netter, 75012 Paris, France. Electronic address: didier.moissenet@aphp.fr.
authors.forename: Didier
authors.initials: D
authors.lastname: Moissenet
authors.affiliation: AP-HP, Hôpital Trousseau-La Roche Guyon, Service de Diététique, 26 av. du Docteur Arnold-Netter, 75012 Paris, France. Electronic address: karine.markowicz@gmail.com.
authors.forename: Karine
authors.initials: K
authors.lastname: Markowicz
authors.affiliation: AP-HP, Hôpital St Antoine, Service de Maladies Infectieuses et Tropicales, 34 rue Crozatier, F-75012 Paris, France. Electronic address: nadia.valin@aphp.fr.
authors.forename: Nadia
authors.initials: N
authors.lastname: Valin
authors.affiliation: AP-HP, Hôpital Trousseau-La Roche Guyon, Service d'Hématologie-oncologie pédiatrique, 26 av. du Docteur Arnold-Netter, 75012 Paris, France. Electronic address: guy.leverger@aphp.fr.
authors.forename: Guy
authors.initials: G
authors.lastname: Leverger
authors.affiliation: AP-HP, Hôpital St Antoine, Service de Parasitologie-Mycologie, 34 rue Crozatier, F-75012 Paris, France; Sorbonne Universités, UPMC Univ Paris 06, Inserm UMR S 1135, CNRS ERL 8255, Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), 91 Bd de l'hôpital, F-75013 Paris, France. Electronic address: christophe.hennequin-sat@aphp.fr.
authors.forename: Christophe
authors.initials: C
authors.lastname: Hennequin
mesh_terms: D000293:Adolescent; D002175:Candida / Q000302:isolation & purification; D002177:Candidiasis / Q000175:diagnosis / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D019337:Hematologic Neoplasms / Q000150:complications* / Q000382:microbiology; D006801:Humans; D007223:Infant; D000072742:Invasive Fungal Infections / Q000175:diagnosis* / Q000382:microbiology; D008297:Male; D011237:Predictive Value of Tests; D012372:ROC Curve; D011933:Reagent Kits, Diagnostic; D012680:Sensitivity and Specificity; D047071:beta-Glucans / Q000097:blood* / Q000302:isolation & purification
chemical_list: D011933:Reagent Kits, Diagnostic; D047071:beta-Glucans
keywords: (1,3)-Beta-D-glucan; Diagnosis; Follow up; Hematological malignancy; Invasive fungal infection; Pediatrics