Contribution of (1,3)-Beta-
            <scp>d</scp>
            -Glucan to Diagnosis of Invasive Candidiasis after Liver Transplantation

Levesque, Éric; Anbassi, Sarra El; Sitterlé, Emilie; Foulet, F.; Merle, Jean‐Claude; Botterel, Françoise

doi:10.1128/jcm.03018-14

Cited by 29 publications

(20 citation statements)

References 26 publications

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“…Fungal colonization is often difficult to differentiate from true infection especially when the samples are positive for fungal elements from non‐sterile sites. Several studies have demonstrated the usefulness of serum biomarkers like Galactomannan index (GMI) and 1,3‐β D Glucan (BDG) as an adjunct for the diagnosis of IFI in general population, haematological malignancies and post–liver transplant recipients . However, their role has not been evaluated in patients with ACLF.…”

Section: Introductionmentioning

confidence: 99%

“…Several studies have demonstrated the usefulness of serum biomarkers like Galactomannan index (GMI) and 1,3-β D Glucan (BDG) as an adjunct for the diagnosis of IFI in general population, 8 haematological malignancies 9 and post-liver transplant recipients. 10,11 However, their role has not been evaluated in patients with ACLF.…”

Section: Introductionmentioning

confidence: 99%

“…Figure S2)were likely to have IFI (30 [90.9%] vs 9 [42.9%]; P < 0.001), invasive ventilation (21 [63.6%] vs 4 [19.0%]; P = 0.001), need for hemodialysis (17 [51.5%] vs 4 [19.0%]; P = 0.017), presence of jaundice (32 [97.0%] vs 16 [76.2%]; P = 0.028), cerebral OF (25 [75.8%] vs 3 [14.3%]; P < 0.001), respiratory OF (16 [48.5%] vs 4 [19.0%]; P = 0.029), circulatory OF (26 [78.8%] vs 6 [28.6%]; P < 0.001), higher Model For End-Stage Liver Disease (MELD) scores (35 [14-40] vs 26.0; P = 0.021), higher CLIF-OF score (14[10][11][12][13][14][15][16][17][18] vs 11[7][8][9][10][11][12][13][14][15]; P < 0.001) and higher CLIF-C ACLF scores (68 [46-119] vs 48 [32-67]; P < 0.001). On multivariate logistic regression analysis, the CLIF-C ACLF score (OR 1.146 [95% CI: 1.054-1.246]; P = 0.001) and presence of IFI (OR 6.227 [95% CI: 1.157-33.514]; P = 0.033) were the independent predictors of mortality.…”

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confidence: 99%

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Invasive fungal infections amongst patients with acute‐on‐chronic liver failure at high risk for fungal infections

Verma

Taneja

Duseja

et al. 2018

Liver International

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Aims To study the prevalence, risk factors, role of serum biomarkers for diagnosis and impact of invasive fungal infections (IFIs) in patients with acute‐on‐chronic liver failure (ACLF). Methods An analysis of IFI in patients with ACLF (EASL criteria) was conducted retrospectively. The diagnosis of IFI in clinically suspected patients was based on EORTC/MSG criteria. The demographical, clinical, laboratory details and outcomes were analysed. Results Out of 264 patients with ACLF, 54 (20.4%) patients with suspicion of IFI were evaluated and IFI was diagnosed in 39 (14.7%). Invasive candidiasis was documented in 25 (64.1%) and invasive aspergillosis in 14 (35.8%). The most common source of infection was respiratory (n = 13) followed by renal (n = 7) and spontaneous fungal peritonitis (n = 6). On univariate analysis, diabetes mellitus, hemodialysis, prior antibiotic use, cerebral and respiratory organ failures, Chronic Liver Failure Consortium (CLIF‐OF and CLIF‐C ACLF) scores were predictors for development of IFI (P < 0.05). On multivariate analysis, hemodialysis and prior antibiotics use predicted the development of IFI (P < 0.05). Non‐survivors were more likely to have IFI (P = 0.029), high CLIF‐OF and CLIF‐C ACLF scores (P < 0.001; for both) and higher 1,3‐β D Glucan (BDG) levels (P = 0.009). The sensitivity, specificity, and AUROC of BDG (80 pg/mL) and Galactomannan index (GMI [0.5]) for diagnosing IFI were 97.4%, 60%, 0.770% and 43.6%, 100%, 0.745 respectively. Conclusions Invasive fungal infections constitutes an important cause of mortality in ACLF patients. BDG and GMI can be useful markers to guide antifungal therapy in patients at high risk for IFI.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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confidence: 99%

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Invasive fungal infections amongst patients with acute‐on‐chronic liver failure at high risk for fungal infections

Verma

Taneja

Duseja

et al. 2018

Liver International

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“…This low incidence can be in part related to delayed or missed diagnoses owing to the lack of sensitivity and specificity of actual diagnostic tests. The early positivity and excellent sensibility of BG assay, which we observed in a previous study in a population of liver transplants , suggest that the detection of BG in the PF may help the diagnosis of PF yeast contamination and support the decision to promptly start pre‐emptive antifungal therapy. However, this test did not exist at the period of our study.…”

Section: Discussionmentioning

confidence: 53%

Fungal complications afterCandidapreservation fluid contamination in liver transplant recipients

et al. 2015

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Summary Donor‐derived fungal infections can be associated with severe complications in transplant recipients. Donor‐derived candidiasis has been described in kidney transplant recipients where contamination of the preservation fluid (PF) was a commonly proposed source. In liver transplantation, these fungal infections have been less explored. The aim of this study was therefore to determine the incidence and clinical relevance of Candida contamination of preservation fluid in the context of liver transplantation. A 5‐year (2008–2012) retrospective multicentre study involving six French liver transplantation centers was performed to determine the incidence of Candida PF contamination. Postoperative clinical features, outcomes in recipients, and risk factors for Candida‐related complications of liver transplantation were studied. Candida sp. was isolated from 28 of 2107 preservation fluid samples (1.33%). Candida albicans was the most common yeast (n = 18, 64%). Twenty‐two recipients (78.5%) received antifungal therapy (echinocandins in 68%) for 7–37 days. Eight patients developed yeast‐related complications (28.6%) including hepatic artery aneurysms (n = 6) and Candida peritonitis (n = 2). The 1‐year mortality rate among patients after a yeast‐related complication was 62.5%. The incidence of Candida PF contamination was low, but was associated with dramatic postoperative complications and high mortality. Close radiological follow‐up may enable early recognition of the arterial complications associated with PF contamination by Candida.

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“…β‐D‐glucan is a cell wall polysaccharide present in fungi and primarily used for the diagnosis of invasive candidiasis, which is emerging as an important serological marker of candida infection . Various studies have used it primarily to diagnose invasive candidiasis in patients with leukemia and carcinomas, as well as in a post‐transplant setting . To our knowledge, none of the above mentioned studies have examined the role of serum β‐D‐glucan in diagnosing candidiasis in UC.…”

Section: Introductionmentioning

confidence: 99%

Colonic mucosa‐associated candida assessed by biopsy culture is associated with disease severity in ulcerative colitis: A prospective study

Shah

Dutta

Rudramurthy

et al. 2019

J of Digest Diseases

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Objective: To evaluate the relationship of mucosa-associated candida (MAC) and disease severity in patients with ulcerative colitis (UC).Methods: We prospectively investigated the presence, nature, and quantification of MAC in patients with UC and its relationship with disease severity. Consecutive patients with UC were assessed for clinical, endoscopic, histological features and serum markers of disease severity. All patients underwent mucosal brushing cytology, brushing culture, and biopsy culture for candida growth. MAC was considered present if mucosal biopsy culture grew candida. Candida spp. identification was performed by matrix-assisted laser desorption/ionization. Serum β-D-glucan was measured with a Fungitell assay. Patients with irritable bowel syndrome who had undergone similar investigations were included as controls.Results: Ninety-six patients with UC showed evidence of MAC more often than the controls (n = 20) based on biopsy culture (33.3% vs 5.0%, P = 0.011), brush cytology (30.2% vs 5.0%, P = 0.019), and brush culture (36.5% vs 10.0%, P = 0.021). Patients with UC had higher candida colony counts (≥10 3 CFU/mL) than controls (34.4% vs 5.0%, P = 0.007). Median β-D-glucan values were higher in patients with UC than in controls (103.26 pg/mL vs 66.51 pg/mL, P = 0.011). The UC group with MAC had a higher median total Mayo score, C-reactive protein, fecal calprotectin, β-D-glucan, and histological activity than those without MAC.Conclusions: Patients with UC more often show evidence of MAC and a higher candida colony count than controls. The presence of MAC is associated with high disease severity in patients with UC. K E Y W O R D S C-reactive protein, erythrocyte sedimentation rate, fecal calprotectin, β-D-glucan; ulcerative colitis The abstract of this article has been published on the Indian Journal of Gastroenterology. 2018;37(Suppl 1): A19-A20 and in the Journal of Crohn's and Colitis. 2019;13(Suppl): S545-S546.

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Contribution of (1,3)-Beta- d -Glucan to Diagnosis of Invasive Candidiasis after Liver Transplantation

Cited by 29 publications

References 26 publications

Invasive fungal infections amongst patients with acute‐on‐chronic liver failure at high risk for fungal infections

Invasive fungal infections amongst patients with acute‐on‐chronic liver failure at high risk for fungal infections

Fungal complications afterCandidapreservation fluid contamination in liver transplant recipients

Colonic mucosa‐associated candida assessed by biopsy culture is associated with disease severity in ulcerative colitis: A prospective study

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