Prospective study in critically ill non-neutropenic patients: diagnostic potential of (1,3)-β-D-glucan assay and circulating galactomannan for the diagnosis of invasive fungal disease

Acosta, José A.; Catalán, M.; Palacio-Pérez-Medel, Ángel del; Montejo, Juan Carlos; de-la-Cruz-Bertolo, J.; Moragues, Marı́a D.; Pontón, José; Finkelman, Malcolm; Palacio, Amalia del

doi:10.1007/s10096-011-1365-0

Cited by 41 publications

(15 citation statements)

References 47 publications

(74 reference statements)

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“…Although culturing of the organism is considered the gold standard of etiological diagnosis, it has poor sensitivity and requires a large quantity of specimen and laboratory infrastructure. For serum antigen detection of pulmonary fungal infection, the G test and GM test are important noninvasive diagnostic methods, with a good sensitivity and specificity for candidiasis and aspergillosis [29].…”

Section: Discussionmentioning

confidence: 99%

“…The average time from first symptoms to diagnosis for aspergillosis, cryptococcosis, and mucormycosis was 123 (4-500) days, 37 (7-150) days, and 22 (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30) days, respectively. The chief clinical symptoms were cough (n = 27, 77.1 %), hemoptysis (n = 17, 48.6 %), moist crackles (n = 7, 20.0 %), and fever (n = 5, 14.3 %).…”

Section: Clinical Manifestationsmentioning

confidence: 99%

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Pulmonary Fungal Diseases in Immunocompetent Hosts: A Single-Center Retrospective Analysis of 35 Subjects

et al. 2016

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Section: Discussionmentioning

confidence: 99%

Section: Clinical Manifestationsmentioning

confidence: 99%

Pulmonary Fungal Diseases in Immunocompetent Hosts: A Single-Center Retrospective Analysis of 35 Subjects

et al. 2016

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“…Because these cell wall polysaccharides are shed into the circulation during infection, elevated serum BG levels can be used to diagnose fungal pneumonia in both immunosuppressed and non-immunosuppressed populations [6-8]. Lower BG levels can also be detected in serum samples from healthy individuals, presumably from sloughing of commensal fungus into the bloodstream [9, 10].…”

Section: Introductionmentioning

confidence: 99%

“…BG is highly immunogenic. It activates macrophages, neutrophils, and T-cells and stimulates release of pro-inflammatory cytokines such as interleukin (IL)-8, tumor necrosis factor (TNF)-α, and IL-6 [6, 11, 12]. Whether BG is detectable in the serum of stable HIV-infected individuals and is associated with immune activation is currently unknown.…”

Section: Introductionmentioning

confidence: 99%

Serum (1→3)-β-D-Glucan Levels in HIV-Infected Individuals Are Associated With Immunosuppression, Inflammation, and Cardiopulmonary Function

Morris

Hillenbrand²,

Finkelman

et al. 2012

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Background Translocation of gastrointestinal bacteria in HIV-infected individuals is associated with systemic inflammation, HIV progression, mortality, and co-morbidities. HIV-infected individuals are also susceptible to fungal infection and colonization, but whether fungal translocation occurs and influences HIV progression or co-morbidities is unknown. Methods Serum (1→3)-β-D-glucan was measured by a Limulus Amebocyte Lysate assay (Fungitell®) in 132 HIV-infected outpatients. Selected plasma cytokines and markers of peripheral T-cell activation were measured. Pulmonary function testing and Doppler-echocardiography were performed. Relationship of high (≥40pg/ml) and low (<40pg/ml) levels of (1→3)-β-D-glucan with HIV-associated variables, inflammation markers, and pulmonary function and pulmonary hypertension measures were determined. Results Forty-eight percent had detectable (1→3)-β-D-glucan, and 16.7% had high levels. Individuals with high (1→3)-β-D-glucan were more likely to have CD4 counts below 200 cells/μl (31.8% vs. 8.4%, p=0.002), had higher log10 HIV viral levels (2.85 vs. 2.13 log copies/ml, p=0.004), and were less likely to use ART (68.2% vs. 90.0%, p=0.006). Plasma IL-8 (p=0.033), TNF-α (p=0.029), and CD8+CD38+ (p=0.046) andCD8+HLA-DR+ (p=0.029) were also increased with high levels. Abnormalities in diffusing capacity (p=0.041) and in pulmonary artery pressures (p=0.006 for pulmonary artery systolic pressure and 0.013 for tricuspid regurgitant velocity) were more common in those with high (1→3)-β-D-glucan. Conclusions We found evidence of peripheral fungal cell wall polysaccharides in an HIV-infected cohort. We also demonstrated an association between high serum (1→3)-β-D-glucan, HIV-associated immunosuppression, inflammation, and cardiopulmonary co-morbidity. These results implicate a new class of pathogen in HIV-associated microbial translocation and suggest a role in HIV progression and co-morbidities.

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“…The different kinetics of (1,3)-b-D-glucan and galactomannan on serum of patients with lA, have been evaluated by numerous studies (27)(28)(29)(30)(31), carried out on different categories of patients. Nevertheless, no substantial differences between the two assays have been documented; the performances remain sub-optimal for both, opening to a combined use of the two tests, that in turn may enhance the accuracy of the laboratory diagnosis in patients at risk of IA.…”

Section: The 3 Rd European Conference On Infections In Leukemia (Ecilmentioning

confidence: 99%

Routine Use of a Protease Zymogen-Based Colorimetric Assay for the Detection of Beta-Glucan and its Role in Clinical Practice

Farina

Lombardi²,

Andreoni³

et al. 2014

Int J Immunopathol Pharmacol

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The detection of Aspergillus antigen (galactomannan) is considered a reliable marker for the diagnosis of invasive aspergillosis (IA), yet the sensibility and specificity of the assays commonly employed in routine are not optimal. The aim of the present study was to investigate whether the detection of another panfungal antigen, the (1,3)-b-D-glucan could have an auxiliary role in the identification of patients with IA. The study was carried out on 63 sera belonging to patients who had been screened for galactomannan, according to the clinical suspect of IA. Our data show that the positive galactomannan results were not confirmed by positive (1,3)-b-D-glucan results in patients receiving therapy with beta-lactam antibiotics associated with tazobactam, whereas in all the other cases, with the exception of four, the results of the (1,3)-b-D-glucan test were confirmatory of the galactomannan results.

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Prospective study in critically ill non-neutropenic patients: diagnostic potential of (1,3)-β-D-glucan assay and circulating galactomannan for the diagnosis of invasive fungal disease

Cited by 41 publications

References 47 publications

Pulmonary Fungal Diseases in Immunocompetent Hosts: A Single-Center Retrospective Analysis of 35 Subjects

Pulmonary Fungal Diseases in Immunocompetent Hosts: A Single-Center Retrospective Analysis of 35 Subjects

Serum (1→3)-β-D-Glucan Levels in HIV-Infected Individuals Are Associated With Immunosuppression, Inflammation, and Cardiopulmonary Function

Routine Use of a Protease Zymogen-Based Colorimetric Assay for the Detection of Beta-Glucan and its Role in Clinical Practice

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