Diagnosis of Invasive Fungal Disease Using Serum (1.RAR.3)-.BETA.-D-Glucan: A Bivariate Meta-Analysis

Lü, Yuan; Chen, Yiqiang; Guo, Yaling; Qin, Simeng; Wu, Cong; Wang, Ke

doi:10.2169/internalmedicine.50.6175

Cited by 81 publications

(51 citation statements)

References 34 publications

(98 reference statements)

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“…Meanwhile the summary positive/negative likelihood ratios (pooled PLR and pooled NLR, respectively) were also calculated. A value of pooled PLR greater than 10 and of pooled NLR less than 0.1 were noted as providing convincing diagnostic evidence, while those value more than 5 and less than 0.2 respectively providing strong diagnostic evidence [19], [20]. The between-study heterogeneity was evaluated by the I-square statistic.…”

Section: Methodsmentioning

confidence: 99%

Systematic Review and Meta-Analysis of Detecting Galactomannan in Bronchoalveolar Lavage Fluid for Diagnosing Invasive Aspergillosis

et al. 2012

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BackgroundBronchoalveolar lavage (BAL) galactomannan (GM) assay has been used for diagnosing invasive aspergillosis (IA). We aimed to derive a definitive estimate of the overall accuracy of BAL-GM for diagnosing IA.Methods and ResultsWe undertook a systematic review of thirty diagnostic studies that evaluated the BAL-GM assay for diagnosing IA. PubMed and CBM (China Biological Medicine Database) databasees were searched for relevant studies published in all languages up until Feb 2012. The pooled diagnostic odds ratio (DOR) and summary receiver operating characteristic (SROC) were constructed for each cutoff value. Additionally, pooled sensitivity (SEN), specificity (SPE), and positive and negative likelihood ratios (PLR and NLR, respectively) were calculated for summarizing overall test performance. Thirty studies were included in this meta-analysis. The summary estimates of pooled DOR, SEN, SPE, PLR, and NLR of the BAL-GM assay (cutoff value 0.5) for proven or probable IA were 52.7 (95% confidence interval (CI) 31.8–87.3), 0.87 (95% CI 0.79–0.92), 0.89 (95% CI 0.85–0.92), 8.0 (95% CI 5.7–11.1) and 0.15 (95% CI 0.10–0.23) respectively. The SROC was 0.94 (95% CI 0.92–0.96). Compared with cutoff value of 0.5, it has higher DOR, SPE and PLR, and similar SEN and NLR with cutoff value of 1.0, which indicated the optimal cutoff value might be 1.0. Compared with BAL-GM, serum GM has a lower SEN and higher SPE, while PCR displays a lower SEN and a similar SPE.ConclusionWith the optimal cutoff value of 1.0, the BAL-GM assay has higher SEN compared to PCR and serum GM test. It is a useful adjunct in the diagnosis of proven and probable IA.

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Section: Methodsmentioning

confidence: 99%

Systematic Review and Meta-Analysis of Detecting Galactomannan in Bronchoalveolar Lavage Fluid for Diagnosing Invasive Aspergillosis

et al. 2012

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“…Using a cutoff value of 80 pg/mL in patients with proven IC, in meta-analyses of BDG studies, the pooled sensitivity and specificity for diagnosing IC were 75% to 80% and 80%, respectively. [26][27][28] Its performance is optimized by requiring 2 successive positive assays to define a true-positive result. Truepositive results are not specific for IC; for this reason, among patient populations who are also at risk for invasive mold infections, such as hematopoietic cell transplant recipients, BDG offers a theoretic advantage over other assays.…”

Section: Diagnosismentioning

confidence: 99%

Invasive Candidiasis

McCarty

Pappas

2016

Infectious Disease Clinics of North America

229

215

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Invasive candidiasis is a collective term that refers to a group of infectious syndromes caused by a variety of species of Candida, 5 of which cause most cases. Candidemia is the most commonly recognized syndrome associated with invasive candidiasis. Certain conditions may influence the likelihood for one species versus another in a specific clinical scenario, and this can have important implications for selection of antifungal therapy and the duration of treatment. Molecular diagnostic technology plays an ever-increasing role as an adjunct to traditional culture-based diagnostics, offering significant potential toward improvement in patient care.

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“…The value of serum galactomannan (GM) and (1, 3)-β-Dglucan (BG) assays are well documented for the early diagnosis of IPA in patients with neutropenia (7)(8)(9). However, there is limited data on these serum markers for testing nonneutropenic patients who are at risk of IPA, and the value of the combination of both tests for this patient population remains unclear.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Value of the Serum Galactomannan and (1, 3)-β-D-glucan Assays for Invasive Pulmonary Aspergillosis in Non-neutropenic Patients

Cai

Wei

et al. 2014

Intern. Med.

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Objective Galactomannan (GM) and (1, 3)-β-D-glucan (BG) are considered useful seromarkers for the diagnosis of invasive pulmonary aspergillosis (IPA) in patients with neutropenia. However, there is still limited data on these seromarkers for testing non-neutropenic patients who are at the risk of IPA. The aim of this study was to evaluate the value of these two serum antigen assays for the early diagnosis of IPA in patients without neutropenia. Methods Between January 2011 and December 2012, 97 patients with suspected IPA admitted to the department of respiratory diseases and the respiratory intensive care unit were prospectively monitored. Serum GM and BG assays were performed before the patients received antifungal therapy. Results Patients were classified as proven IPA (n=11), probable IPA (n=16), possible IPA (n=4), or non-IPA (n=66). The most common underlying disease of patients with IPA was chronic obstructive pulmonary disease (18.5%), and 22.2% patients with IPA had no known diseases. The sensitivities, specificities, and positive and negative predictive values of the GM and BG assays and at least one positive on both assays were 40.7%/89.4%/61.1%/78.7%, 48.1%/78.8%/48.1%/78.8%, and 70.4%/75.8%/54.3%/86.2%, respectively. Conclusion Compared with the testing of neutropenic patients, the serum GM or BG assay alone was less useful for the diagnosis of IPA in non-neutropenic patients. However, at least one positive result of the two serum assays appeared to be useful in the diagnosis of IPA in non-neutropenic patients.

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Diagnosis of Invasive Fungal Disease Using Serum (1.RAR.3)-.BETA.-D-Glucan: A Bivariate Meta-Analysis

Cited by 81 publications

References 34 publications

Systematic Review and Meta-Analysis of Detecting Galactomannan in Bronchoalveolar Lavage Fluid for Diagnosing Invasive Aspergillosis

Systematic Review and Meta-Analysis of Detecting Galactomannan in Bronchoalveolar Lavage Fluid for Diagnosing Invasive Aspergillosis

Invasive Candidiasis

Diagnostic Value of the Serum Galactomannan and (1, 3)-β-D-glucan Assays for Invasive Pulmonary Aspergillosis in Non-neutropenic Patients

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