Rautemaa Vilma, Green Heather D, Jones Andrew M, Rautemaa-Richardson Riina
School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Oxford Road, Manchester, M13 9PL, UK.
Manchester Adult Cystic Fibrosis Centre, University Hospital of South Manchester, Southmoor Road, Manchester, M23 9LT, UK; Division of Infection, Immunity and Respiratory Medicine, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Southmoor Road, Manchester, M23 9LT, UK.
Diagn Microbiol Infect Dis. 2017 Aug;88(4):316-321. doi: 10.1016/j.diagmicrobio.2017.05.010. Epub 2017 May 18.
β-(1,3)-d-glucan (BDG) is used to rule out invasive fungal disease (IFD) but its usefulness in cystic fibrosis (CF) has not been evaluated. We measured serum BDG in CF patients with no clinical suspicion of IFD. Samples from 46 adult CF patients during a stable period and during pulmonary exacerbation were tested. The association of BDG with clinical variables was analyzed. Three hundred and three non-CF patients with suspected IFD were used as comparators. Both samples were negative in 52% of CF patients, whereas 67% of comparators had only negative results (P=0.08). CF patients with pancreatic insufficiency and CF-related diabetes had fewer negative results (P<0.05 for both). Negative results were more common in older CF patients (P<0.05). Use of antibiotics, presence of fungi in sputum and CF liver disease did not impact BDG levels. In conclusion, patients with CF experience significant BDG antigenaemia in the absence of IFD.
β-(1,3)-D-葡聚糖（BDG）用于排除侵袭性真菌病（IFD），但其在囊性纤维化（CF）中的作用尚未得到评估。我们对临床上未怀疑患有IFD的CF患者的血清BDG进行了检测。对46例成年CF患者在病情稳定期和肺部加重期的样本进行了检测。分析了BDG与临床变量之间的关联。303例疑似IFD的非CF患者作为对照。52%的CF患者样本结果均为阴性，而67%的对照者仅为阴性结果（P = 0.08）。合并胰腺功能不全和CF相关糖尿病的CF患者阴性结果较少（两者P均<0.05）。阴性结果在年龄较大的CF患者中更为常见（P<0.05）。使用抗生素、痰液中存在真菌以及CF肝病均不影响BDG水平。总之，在无IFD的情况下，CF患者存在显著的BDG抗原血症。
