Kaita Yasuhiko, Tarui Takehiko, Otsu Akiyasu, Tanaka Yuya, Suzuki Jun, Yoshikawa Kei, Yamaguchi Yoshihiro
Department of Trauma and Critical Care Medicine, Kyorin University School of Medicine, Tokyo, Japan.
J Burn Care Res. 2019 Jan 1;40(1):104-106. doi: 10.1093/jbcr/iry055.
Although the serum 1,3-β-D-glucan test has been used as an early diagnostic marker of candidemia, there are few studies regarding the association of serum 1,3-β-D-glucan levels with candidemia in severe burn patients. The purpose of this study was to elucidate the clinical significance of 1,3-β-D-glucan for the diagnosis of candidemia in severe burn patients. Data from 51 severe burn patients whose serum levels of 1,3-β-D-glucan had been measured for the suspicion of invasive fungal infection were analyzed retrospectively. The primary outcome in this study was the detection of candidemia. The levels of 1,3-β-D-glucan (pg/ml) in candidemia and noncandidemia groups ranged from 41.1 to 600.0 with a median of 90.6 and from 5.0 to 41.3 with a median of 6.8, respectively. A significant difference in the levels of 1,3-β-D-glucan was observed between the two groups. The optimal cutoff value was 40 pg/ml, with a sensitivity of 100% and a specificity of 95%, whereas the conventional cutoff value (11 pg/ml) resulted in a sensitivity of 100% and a specificity of 68%. The 1,3-β-D-glucan test was found to be useful for detecting candidemia in severe burn patients, and the cutoff value might be set to 40 pg/ml to detect it more accurately.
尽管血清1,3-β-D-葡聚糖检测已被用作念珠菌血症的早期诊断标志物，但关于严重烧伤患者血清1,3-β-D-葡聚糖水平与念珠菌血症之间关联的研究较少。本研究的目的是阐明1,3-β-D-葡聚糖在严重烧伤患者念珠菌血症诊断中的临床意义。对51例因怀疑侵袭性真菌感染而检测血清1,3-β-D-葡聚糖水平的严重烧伤患者的数据进行回顾性分析。本研究的主要结果是念珠菌血症的检测。念珠菌血症组和非念珠菌血症组的1,3-β-D-葡聚糖水平（pg/ml）分别为41.1至600.0，中位数为90.6，以及5.0至41.3，中位数为6.8。两组之间1,3-β-D-葡聚糖水平存在显著差异。最佳临界值为40 pg/ml，敏感性为100%，特异性为95%，而传统临界值（11 pg/ml）的敏感性为100%，特异性为68%。发现1,3-β-D-葡聚糖检测对严重烧伤患者念珠菌血症的检测有用，临界值可设定为40 pg/ml以更准确地检测。
