The Burn Center, Department of Surgery, Washington Hospital Center, Washington, DC 20010, USA.
Mycoses. 2012 May;55(3):224-7. doi: 10.1111/j.1439-0507.2011.02068.x. Epub 2011 Jul 19.
Serum (1→3)-β-D-glucan (BG) is increasingly used as diagnostic marker for invasive fungal infections. Exposure to gauze may lead to false-positive BG assays. The role of BG is unclear in thermally injured patients who frequently require extensive gauze coverage; therefore, we prospectively evaluated BG levels in burn-injured patients. Serum BG levels were measured in 18 burn patients immediately before application of the first dressing and 12 h after. Patients were stratified by extent of total body surface area (TBSA) requiring gauze coverage: <20%, 20-39%, 40-60% and >60%. BG levels were obtained from patients with non-burn trauma as controls. BG results were positive (>80 pg ml⁻¹) in 9/18 (50%) patients at baseline and in 8/18 (44%) 12 h after application of the first dressing. BG levels were positive in 1/5 (20%) of patients with <20% TBSA requiring gauze and in 10/13 (77%) with ≥ 20% (P < 0.05). None of the control patients had positive BG at any time point and none of the patients had candidemia at baseline. Mean serum BG levels decreased (19.44 pg ml⁻¹) after gauze placement. False-positive serum BG elevations are common in this patient population. Positivity correlates with extent of TBSA injured, but is not impacted by the gauze itself.
血清（1→3）-β-D-葡聚糖（BG）越来越多地被用作侵袭性真菌感染的诊断标志物。接触纱布可能导致 BG 检测出现假阳性。在经常需要广泛覆盖纱布的热烧伤患者中，BG 的作用尚不清楚；因此，我们前瞻性地评估了烧伤患者的 BG 水平。在首次敷药前和 12 小时后，对 18 名烧伤患者立即测量了血清 BG 水平。患者按总体表面积（TBSA）需要纱布覆盖的程度分层：<20%、20-39%、40-60%和>60%。非烧伤创伤患者的 BG 结果作为对照。在基线时，18 例患者中有 9 例（50%）BG 结果阳性（>80 pg ml⁻¹），在首次敷药后 12 小时有 8 例（44%）BG 结果阳性。在 TBSA<20%需要纱布覆盖的患者中，有 1 例（20%）BG 结果阳性，在 TBSA≥20%的患者中，有 10 例（77%）BG 结果阳性（P<0.05）。在任何时间点，对照组均无患者的 BG 结果阳性，基线时也无患者发生念珠菌血症。纱布放置后，血清 BG 水平下降（19.44 pg ml⁻¹）。在该患者人群中，假阳性血清 BG 升高很常见。阳性结果与 TBSA 损伤程度相关，但与纱布本身无关。
