title: Comparative evaluation of pan-fungal real-time PCR, galactomannan and (1-3)-β-D-glucan assay for invasive fungal infection in paediatric cancer patients.
abstract: Limited specific data and investigations are available for the diagnosis of Invasive Fungal Infection (IFI) in paediatrics cancer patients. Three non-invasive tests; Platelia Aspergillus EIA for galactomannan (GM), β-D-glucan (BDG) assay and pan-fungal real-time PCR for fungal DNA in blood were evaluated. One hundred twenty-five paediatrics cancer patients at the high risk of IFI were enrolled. Single blood and serum samples were evaluated by all the three methods. Patients were classified into 10 proven, 52 probable and 63 no IFI cases in accordance with EORTC MSG 2008 revised guidelines. The sensitivity, specificity, PPV and NPV of all the three tests in proven, probable and no IFIs cases were analysed singly and in combination. The sensitivity, specificity, PPV and NPV of GM, BDG and pan-fungal real-time PCR were: 87%, 61%, 81%, 69.5% for GM, 88%, 59.5%, 81%, 71.4% for BDG and 89%, 69.2%, 85%, 67.5% for PCR (95% CI). Among different combinations, best combination was found to be GM and PCR with sensitivity, specificity, PPV and NPV of 98.2%, 89.3%, 97.1% and 90% respectively. Single samples must be evaluated by combination of tests.
authors.affiliation: Department of Microbiology, King George's Medical University, Lucknow, India.
authors.forename: Prashant
authors.identifier: http://orcid.org/0000-0002-6925-3546
authors.initials: P
authors.lastname: Gupta
authors.affiliation: Department of Microbiology, King George's Medical University, Lucknow, India.
authors.forename: Abrar
authors.initials: A
authors.lastname: Ahmad
authors.affiliation: Department of Microbiology, Era's Lucknow Medical College, Lucknow, India.
authors.forename: Vineeta
authors.initials: V
authors.lastname: Khare
authors.affiliation: Department of Pediatrics, King George's Medical University, Lucknow, India.
authors.forename: Archana
authors.initials: A
authors.lastname: Kumar
authors.affiliation: Department of Microbiology, King George's Medical University, Lucknow, India.
authors.forename: Gopa
authors.initials: G
authors.lastname: Banerjee
authors.affiliation: Department of Otorhinolaryngology, King George's Medical University, Lucknow, India.
authors.forename: Nitya
authors.initials: N
authors.lastname: Verma
authors.affiliation: Department of Microbiology, King George's Medical University, Lucknow, India.
authors.forename: Mastan
authors.initials: M
authors.lastname: Singh
mesh_terms: D000293:Adolescent; D000946:Antigens, Fungal / Q000097:blood; D002648:Child; D002675:Child, Preschool; D004271:DNA, Fungal / Q000097:blood; D005658:Fungi / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification*; D005690:Galactose / Q000031:analogs & derivatives; D006801:Humans; D007118:Immunoassay / Q000379:methods*; D007223:Infant; D000072742:Invasive Fungal Infections / Q000097:blood / Q000175:diagnosis* / Q000276:immunology / Q000382:microbiology; D008297:Male; D008351:Mannans / Q000097:blood*; D009369:Neoplasms / Q000150:complications / Q000382:microbiology*; D010361:Patients; D060888:Real-Time Polymerase Chain Reaction / Q000379:methods*; D012680:Sensitivity and Specificity; D047071:beta-Glucans / Q000097:blood*
chemical_list: D000946:Antigens, Fungal; D004271:DNA, Fungal; D008351:Mannans; D047071:beta-Glucans; C012990:galactomannan; D005690:Galactose
keywords: Aspergillosis; candidiasis; galactomannan; invasive fungal infection; pan-fungal real-time PCR; β-D-glucan assay