Evaluation of serum (1 → 3)-β-d-glucan clinical performance: kinetic assessment, comparison with galactomannan and evaluation of confounding factors

Pini, Pietro; Bettua, Clotilde; Orsi, Carlotta Francesca; Venturelli, Claudia; Forghieri, Fabio; Bigliardi, Sara; Faglioni, Laura; Luppi, Fabrizio; Serio, Lucia; Codeluppi, Mauro; Luppi, Mario; Mussini, Cristina; Girardis, Massimo; Blasi, Elisabetta

doi:10.1007/s15010-015-0849-8

Cited by 29 publications

(26 citation statements)

References 37 publications

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“…The problem is that the test is non-specific, resulting in a very low PPV, even if we consider two consecutive positive tests and the 2.7% incidence of fusariosis in our centre, which is much higher than that observed in other regions of the globe. 19,20 The low specificity of BDG has been attributed to frequent false-positive tests related to various factors such as bacteraemia, 9,21 antibiotics, 22 gastrointestinal mucositis 23,24 or surgery, 25 and infusion of blood products. 26 In our study, exposures to potential causes of false-positive BDG test including bacteraemia, use of antibiotics, gastrointestinal mucositis and infusion of blood products were similar in cases and controls.…”

Section: Discussionmentioning

confidence: 99%

Performance of 1,3‐beta‐D‐glucan in the diagnosis and monitoring of invasive fusariosis

Nucci

Barreiros

Reis

et al. 2019

Mycoses

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Summary Invasive fusariosis (IF) usually presents with high fungal burden at diagnosis, and this may contribute to its high mortality rate. The use 1,3‐beta‐D‐glucan (BDG) may help to establish the diagnosis at an earlier disease stage and to monitor treatment. To evaluate the performance of BDG in the diagnosis of IF and its kinetics in relation to the outcome, we retrospectively tested serum samples of 13 cases of IF, analysed the temporal relationship between the first positive BDG test and the date of the diagnosis of IF, and the kinetics of BDG in relation to patients’ outcome. We selected 13 controls with similar underlying diseases as cases, at least two serum samples stored, and no invasive fungal disease. Twelve patients with IF had at least one positive BDG (median 4, range 1‐16). The test was positive before the diagnosis of IF in 11 of the 12 patients (91.6%), at a median of 10 days (range 1‐32). The median BDG value increased (from 109 to 316 pg/mL, P = 0.04) in patients who died by day 30, and did not change significantly (99‐101 pg/mL, P = 0.60) in survivors. Using two consecutive BDG tests, sensitivity, specificity, and positive and negative predictive values were 85%, 69%, 7% and 99%, respectively. BDG is positive in the majority of patients with IF, usually before the diagnosis, but the low positive predictive value limits its use to diagnose IF earlier. Once therapy is started, decreasing BDG values suggests treatment response.

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Section: Discussionmentioning

confidence: 99%

Performance of 1,3‐beta‐D‐glucan in the diagnosis and monitoring of invasive fusariosis

Nucci

Barreiros

Reis

et al. 2019

Mycoses

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“…28 Among the cause of false positivity, previous administration of polyvalent immunoglobulins has been incriminated; as filtration on cellulose filters is part of their manufacturing process, that may release glucan components. 29 Intestinal barrier integrity also seems to be of major importance in false positives. Mucosal injury associated with severe mucositis/colitis due to chemotherapy has been shown to favor false positive BDG result, 30 while Enterococcus digestive colonization and youngest age are known to increase the intestinal permeability.…”

Section: Discussionmentioning

confidence: 99%

Detection of β-D-glucan for the diagnosis of invasive fungal infection in children with hematological malignancy

Guitard

Tabone

Senghor

et al. 2016

Journal of Infection

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“…Investigations have reported a BG sensitivity of 60.0-87.9% and specificity of 78.0-80.5%. [11][12][13] The Galactomannan (GM) test is aimed at a specific antigen for Aspergillus and is used for the early diagnosis of Aspergillus infection. In a systematic literature review on pediatric invasive aspergillosis, the pooled sensitivity and specificity were reported to be 85% and 88%, respectively.…”

Section: Introductionmentioning

confidence: 99%

<p>Emerging Invasive Fungal Infections: Clinical Features and Controversies in Diagnosis and Treatment Processes</p>

Zhang¹,

Zhu²

2020

IDR

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Background: The diagnosis and treatment of invasive fungal infection (IFI) are still challenging due to its complexity and non-specificity. This study was aimed to investigate the clinical features, diagnosis process, and outcomes of patients with emerging IFIs. Methods: A retrospective review of emerging IFIs in adult patients at a university hospital in China was conducted; diagnoses were based on the criteria of EORTC/MSG 2008. Results: 145 IFI patients (pulmonary, intestinal and urinary) were enrolled in this study, including 80 proven (55.2%), 59 probable (40.7%), or 6 possible IFIs (4.1%). Among the 126 pulmonary IFIs, the positivity rate for sputum microscopy, sputum culture, and 1.3-ß-D-glucan (BG) test was 54.0%, 44.4%, and 37.3%, respectively. Among the 19 intestinal and urinary IFIs, routine examination of stool or urine and their culture were the main methods of detection. Positive results of 75 detected fungal strains from the samples showed that 30 cases were complicated with one or more bacterial infections. The average length of hospital stay of IFI patients was 14.0 (10.0, 20.0) days. The time from admission to antifungal therapy initiation (P<0.001), liver cirrhosis (P<0.001), hematological tumor (P<0.001), coinfection (P=0.019) and immune diseases (P=0.025) were independent predictors of prolonged hospitalization. Conclusion: Delayed time was the primary predictor of prolonged hospitalization. This prediction is suggested to improve IFI diagnostic and therapeutic process of IFI to promote prognosis.

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Evaluation of serum (1 → 3)-β-d-glucan clinical performance: kinetic assessment, comparison with galactomannan and evaluation of confounding factors

Cited by 29 publications

References 37 publications

Performance of 1,3‐beta‐D‐glucan in the diagnosis and monitoring of invasive fusariosis

Performance of 1,3‐beta‐D‐glucan in the diagnosis and monitoring of invasive fusariosis

Detection of β-D-glucan for the diagnosis of invasive fungal infection in children with hematological malignancy

<p>Emerging Invasive Fungal Infections: Clinical Features and Controversies in Diagnosis and Treatment Processes</p>

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