Evaluation of Panfungal Marker (1,3)-⃞-D-Glucanin Diagnosis of Invasive Infections with Candida Species

Abstract

Introduction. Although blood culture is considered a gold standard in diagnosis of invasive infections, it is still not reliable and fast enough for diagnosis of candidemia. Determination of serum (1,3)-⃞-D-glucan is a highly sensitive and specific test for invasive mycosis, and could probably be of benefit to patients with high risk for invasive infections with Candida species. Aim. The aim of this study was to prospectively evaluate the diagnostic performance of serum (1.3)-⃞-Dglucan BDG (Fungitell) assay, in comparison with blood culture, for diagnosis of invasive infections with Candida species. Methods. Blood and sera from 120 patients divided in 4 groups, hospitalized at the University clinics in Skopje, during a 2-year period, were investigated for invasive Candida infections. Blood was examined with conventional methods (automated BacT/Alert system, Gram stain and culture on fungal media). Identification of Candida species was performed with VITEK-2 system. Serum (1,3)-⃞-D-glucan was determined by means of Fungitell assay. Results. Positive blood culture was registered in 23.33%, 43.33%, 23.8% and in 3.33% of samples only in groups I, II, III and IV, respectively. Positive findings with (1,3)-⃞-D-glucan Fungitell assay at the same time with blood culture were detected in 83.33%, 76.67%, 30% and 26.67% in groups I, II, III and IV, respectively. The average concentration of BDG was highest in group I, followed by group II, group IV and group III. Conclusion. Our results suggest that a positive (1,3)-⃞-D-glucan assay could be a superior test in addition to the blood culture for diagnosis of candidemia and highlights the value of this test as a diagnostic adjunct in the serodiagnosis of an invasive candidiasis.