Diagnostic value of plasma 1,3-β-D-glucan combined with Candida score in patients with invasive fungal infections

Abstract

Abstract:

Objective To discuss the diagnostic value of plasma 1,3-β-D-glucan (G test) and Candida score (CS) to invasive fungal infection (IFI). Method Collecting clinical information of 201 patients with high risk of invasive Candida infection treated in the ICU of someone hospital from June 2011 to June 2016, according to diagnostic criteria of European cancer research and treatment group and fungal research group (EORTC/MSG), 9 cases as proven were diagnosed as proven, 73 cases as probable, 29 cases as possible, 90 cases as non-invasive infection. Microbiology Kinetic Rapid Reader MB-80 was used to measure the concentration of plasma 1,3-β-D-glucan (exceed 10pg/mL is regarded as positive), and Candida score was utilized in those patients (exceed 3 scores is regarded as positive), then to calculate the sensitivity, specificity, positive predictive value, negative predictive values for G test and Candida score used exclusively or jointly. Result Respiratory tract was the most probable infected site, and Candida albicans was the main pathogenic fungi. In all patients 88 cases was positive by G test, 85 cases is positive by Candida score. Plasma 1,3-β-D-glucan and Candida score were used jointly, whose sensitivity, specificity, positive predictive value, and negative predictive values were 95.1%,71.1%,75.0%,94.1%; compared with plasma 1,3-β-D-glucan and Candida score used exclusively, whose sensitivity and negative predictive value were the highest, specificity and positive predictive value were approximate among them. Conclusion When plasma 1,3-β-D-glucan and Candida score were used jointly, sensitivity and negative predictive value were higher than that were used alone, plasma 1,3-β-D-glucan combined with Candida score had more significant diagnostic value.

Key words: 1,3-β-D-glucan, Candida score, invasive fungal infection, diagnosis

CLC Number:

R519.3

XU Ming-jun, ZHANG Hui-ting, ZHANG Yu-jie, XU Yu-jie, SUN Xiao-peng, MA Xiao-wei. Diagnostic value of plasma 1,3-β-D-glucan combined with Candida score in patients with invasive fungal infections[J]. Chinese Journal of Mycology, 2018, 13(1): 11-14.

References

[1] Lionakis MS, Iliev ID, Hohl TM. Immunity against fungi[J]. JCI Insight, 2017,2(11):93156.
[2] Ostrosky-Zeichner L, Al-Obaidi M. Invasive fungal infections in the intensive care unit[J]. Infect Dis Clin North Am, 2017,31(3):475-487.
[3] Chandra J, Mukherjee PK. Candida biofilms:development, architecture, and resistance[J]. Microbiol Spectr, 2015,3(4). doi:10.1128/microbiolspec.MB-0020-2015.
[4] Wu GX, Khojabekyan M, Wang J, et al. Survival following lung resection in immunocompromised patients with pulmonary invasive fungal infection[J]. Eur J Cardiothorac Surg, 2016,49(1):314-320.
[5] Yapar N. Epidemiology and risk factors for invasive candidiasis[J]. Ther Clin Risk Manag, 2014,10:95-105.
[6] Lockhart SR, Iqbal N, Cleveland AA, et al. Species identification and antifungal susceptibility testing of Candida bloodstream isolates from population-based surveillance studies in two U.S. cities from 2008 to 2011[J]. J Clin Microbiol, 2012,50(11):3435-3442.
[7] Wang H, Xu YC, Hsueh PR. Epidemiology of candidemia and antifungal susceptibility in invasive Candida species in the Asia-Pacific region[J]. Future Microbiol, 2016,11:1461-1477.
[8] Guo F, Yang Y, Kang Y, et al. Invasive candidiasis in intensive care units in China:a multicentre prospective observational study[J]. J Antimicrob Chemother, 2013,68(7):1660-1668.
[9] Angebault C, Lanternier F, Dalle F, et al. Prospective evaluation of serum beta-glucan testing in patients with probable or proven fungal diseases[J]. Open Forum Infect Dis, 2016,3(3):ofw128.
[10] Su KC, Chou KT, Hsiao YH, et al. Measuring (1,3)-beta-D-glucan in tracheal aspirate, bronchoalveolar lavage fluid, and serum for detection of suspected Candida pneumonia in immunocompromised and critically ill patients:a prospective observational study[J]. BMC Infect Dis, 2017,17(1):252.
[11] Leon C, Ruiz-Santana S, Saavedra P, et al. A bedside scoring system ("Candida score") for early antifungal treatment in nonneutropenic critically ill patients with Candida colonization[J]. Crit Care Med, 2006,34(3):730-737.
[12] Leon C, Ruiz-Santana S, Saavedra P, et al. Usefulness of the "Candida score" for discriminating between Candida colonization and invasive candidiasis in non-neutropenic critically ill patients:a prospective multicenter study[J]. Crit Care Med, 2009,37(5):1624-1633.
[13] De Pauw B, Walsh TJ, Donnelly JP, et al. Revised definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) Consensus Group[J]. Clin Infect Dis, 2008,46(12):1813-1821.
[14] Levesque E, Rizk F, Noorah Z, et al. Detection of (1,3)-beta-d-glucan for the diagnosis of invasive fungal infection in liver transplant recipients[J]. Int J Mol Sci, 2017,18(4):862.
[15] Gokahmetoglu G, Mutlu SF, Koc AN, et al. Determination of Candida colonization and Candida score in patients in anesthesia intensive care unit[J]. Mikrobiyol Bul, 2016,50(3):438-448.
[16] De Rosa FG, Corcione S, Montrucchio G, et al. Appropriate treatment of invasive candidiasis in ICU:timing, colonization index, Candida score & biomarkers, towards de-escalation[J]? Turk J Anaesthesiol Reanim, 2016,44(6):279-282.