Clinical value of(1,3)-β-D-glucan in plasma on the diagnosis of deep fungal infection

Abstract

Abstract: Objective To study the value of plasma(1,3)-β-D-glucan and fungal culture on the diagnosis of deep fungal infection.Methods Retrospective investigation were performed on 1 868 patients with fever and treatment of immunosuppressant,corticosteroid or wide-spectrum antibiotics for a long time from August 2009 to July 2010.(1,3)-β-D-glucan concentration in plasm and culture results of peripheral blood,respiratory tract,urinary tract and intestinal canal were analysed.Results Symptoms of 757 cases in 1 868 patients were relieved after antifungal treatment.Other 1 082 cases,showed no improvement or received no antifungal drugs.Another 29 cases(eliminate) had no clinical data.In the 1 839 valuble cases,the detection ratio of(1,3)-β-D-glucan was 778/1 061 with 20 pg/mL as critical value,and 623/1 216 with 50 pg/mL as critical value respectively.Positive to negative rate in fungal culture was 457/1 382.Sensitivity(89.3%,74.9%), specificity(90.6%,94.8%),positive predictive value(PPV,86.9%,91.0%) and negative predictive value(NPV,92.4%,84.4%) obtained by different critical value showed no significal differences(P>0.05).The sensitivity,specificity,PPV and NPV of fungal culture were 49.0%,,92.1%,81.2% and 72.1% respectively.The sensitivity and specificity raised to 93.0% and 88.9% after combination of the two methods.Conclusions G-test for(1,3)-β-D-glucan detection is simple,rapid with high positive rate of fungi detection.It is suggested that G-test,fungal dtermination should be combine in the diagnosis of deep fungal infection for satisfied sensitivity and specificity.

Key words: (1,3)-β-D-glucan, deep fungal infection, fungal culture

CLC Number:

R446.53

YANG Hui-qing, MEI Ya-ning. Clinical value of(1,3)-β-D-glucan in plasma on the diagnosis of deep fungal infection[J]. Chinese Journal of Mycology, 2011, 6(3): 136-140.

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