The value of quantitative PCR detection combined with G test and GM test in the early diagnosis of invasive fungal infections

Abstract

Abstract: Objective To explore the value of RT-PCR (RTFQ-PCR) detection combined with G test and GM test in the early diagnosis of invasive fungal infection. Method From April 2014 to October 2015, 60 cases at high risk of IFI from several departments including ICU of our hospital were enrolled. Fungal culture of blood, phlegm and alveolar lavage tissue samples, plasma (1,3) -β-D-glucan assay (G test), galactomannan antigen assay (GM test) and fluorescence quantitative RTFQ-PCR were performed. The ROC curve analysis was conducted to evaluate the diagnostic value of fluorescence quantitative RTFQ-PCR for IFI. Results G test positive rates of IFI, clinical diagnostic, suspected and excluded groups were 100%, 70.37%, 75.00% and 54.55% respectively; GM detection positive rates were 66.67%, 70.37%, 62.50% and 45.45% respectively; The positive rates of RTFQ-PCR were 100%, 81.48%, 87.50% and 22.73%, respectively. Results of G test: sensitivity was 81.58%, specificity 59.09%, positive predictive value 77.50%, negative predictive value 65.00%, and coincidence was 73.33%. The sensitivity, specificity, positive predictive value and negative predictive value of GM test were 76.32%, 68.18%, 80.56%, 62.50% and 73.33%, respectively. The sensitivity, specificity, positive predictive value, negative predictive value and conformity of RTFQ-PCR were 84.21%, 77.27%, 86.49%, 73.91% and 73.91% respectively. The sensitivity, specificity, positive predictive value and negative predictive value of RTFQ-PCR+G+GM combined detection were 55.26%, 95.45%, 95.45%, 55.26% and 70.00% respectively. Conclusion G test, GM test and RTFQ-PCR test showed high clinical application value in IFI diagnosis (all P < 0.05), but G test and GM test had high false positive rates in IFI diagnosis, so RTFQ-PCR test was recommended in single detection, and RTFQ-PCR+G+GM combined detection could significantly improve the accuracy of IFI clinical diagnosis.

Key words: invasive fungal infection, fungal culture, realtime fluorescence quantitative PCR, joint detection, diagnostic value

CLC Number:

R446.5
R519

SHANG Yuanyuan, LI Kexin, MA Chunmei, LI Shasha, HU Rongying, YANG Wenjun. The value of quantitative PCR detection combined with G test and GM test in the early diagnosis of invasive fungal infections[J]. Chinese Journal of Mycology, 2021, 16(6): 367-372.

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