Reactivity of (1 → 3)-β-d-glucan assay in bacterial bloodstream infections

Abstract

To diagnose invasive fungal infections, the detection of (1 → 3)-β-d-glucan in serum has shown variable specificity, depending on the targeted population. Several circumstances for false-positive results of beta-glucan tests have been identified, among which are severe bacterial infections. In this study, we measured (1 → 3)-β-d-glucan by the Fungitell test in the serum of 62 patients (one serum sample tested per patient) for whom invasive fungal infection was not suspected: 19 control subjects and 43 patients with bacteraemia. The test was interpretable for 58 sera: all 19 control subjects had negative beta-glucan test; among the 39 bacteraemic patients, we report 16 false-positive results. For the 22 patients undergoing bacteraemia due to Gram-negative bacilli, we observed 13 false-positive results (59%). Among the 17 patients with bloodstream infection involving Gram-positive cocci, three false-positive tests were recorded, but none in the eight cases of Streptococcus pneumoniae bacteraemia. Statistical analysis showed that beta-glucan levels were significantly higher in patients with Gram-negative bacilli bloodstream infection in comparison to those with bacteraemia due to Gram-positive cocci. These results were independent from other previously described causes for false-positive beta-glucan tests. These data might help physicians to interpret positive beta-glucan detection when an invasive fungal infection is suspected, especially for patients with bacterial infections.

Bloodstream Infections Are an Improbable Cause of Positive Serum (1,3)-β-d-Glucan in Hematology Patients

“…Only 1 of 18 (5.5%) patients with BSI caused by Gram-positive cocci and 1 of 12 (8%) patients with BSI caused by E. coli were found to be BG positive in our cohort, compared to 66% and 38%, respectively, in other studies (7,9). Note that none of the 23 patients with P. aeruginosa BSI without IFD had a positive BG result.…”

“…However, existing data on the frequency of false-positive BG results during BSI with the aforementioned bacteria are inconsistent (6)(7)(8)(9)(10)(11)(12). While older studies reported up to 66% (10/15) of patients with a BSI due to Grampositive cocci having more than one sample positive for BG, a more recent analysis found only one positive BG result among 70 patients with BSI and no IFD (7,12).…”

Value of β-d-glucan and Candida albicans germ tube antibody for discriminating between Candida colonization and invasive candidiasis in patients with severe abdominal conditions

“…2 Prediction rule for the diagnosis of invasive candidiasis (IC) in nonneutropenic adult critically ill patients with severe abdominal conditions. Each terminal node shows the probability of the predicted event intravenous immunoglobulins, albumin, coagulation factors, and plasma protein fractions [27][28][29]. In addition, Pickering et al [29] showed in a cross-contamination experiment that excess manipulation of a sample can result in its contamination with BDG.…”

“…The reason for ICU admission was medical in 18.8 % of patients, surgical in 76.1 %, and trauma in 5.1 %. The median (IQR) length of ICU and hospital stay was 15 (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27) and 38 (24-57) days, respectively, which were significantly higher in patients with IC compared to the other two groups. ICU and hospital crude mortality rates were 26.7 and 32.4 %, respectively.…”

Comparison of (1→3)-β- d -Glucan, Mannan/Anti-Mannan Antibodies, and Cand-Tec Candida Antigen as Serum Biomarkers for Candidemia

“…Recently, there have been changes concerning these biomarkers. It has been reported that BDG levels are elevated in bacteremia, questioning the validity of this marker for the diagnosis of invasive fungal disease (11,12). However, studies including relevant numbers of bacteremic patients are lacking.…”