Chang Euijin, Kim Taek Soo, Kang Chang Kyung, Jun Kang Il, Shin Dongyeop, Koh Youngil, Hong Junshik, Choe Pyoeng Gyun, Park Wan Beom, Kim Nam-Joong, Yoon Sung-Soo, Kim Inho, Oh Myoung-Don
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
Open Forum Infect Dis. 2020 Feb 12;7(3):ofaa048. doi: 10.1093/ofid/ofaa048. eCollection 2020 Mar.
Diagnostic value of β-d-glucan (BDG) in populations with low prevalence of invasive fungal infection (IFI), such as hematologic patients receiving antimold prophylaxis, should be re-evaluated.
We retrospectively reviewed episodes with BDG results in hematologic patients receiving antimold prophylaxis from January 2017 to August 2019 in a tertiary hospital. The episodes were classified as true positive ([TP] positive BDG with IFI), true negative ([TN] negative BDG without IFI), false positive ([FP] positive BDG without IFI), false negative ([FN] negative BDG with IFI), and nonevaluable.
A total of 203 episodes were analyzed: 101 episodes (49.8%) were from stem cell transplants, 89 (43.8%) were from induction chemotherapy, and 13 (6.4%) were from graft-versus-host disease treatment. There were 62 nonevaluable episodes. Among 141 evaluable ones, there were 8 (5.7%) episodes of probable/proven IFI. True positive, TN, FP, and FN cases were 4 (2.8%), 112 (79.4%), 21 (14.9%), and 4 (2.8%) episodes, respectively. Sensitivity, specificity, positive predictive value, and negative predictive value were 50.0%, 84.2%, 16.1%, and 96.5%, respectively. Positive predictive value was 26.7% and 0.0% in diagnostic and surveillance episodes, respectively.
β-d-glucan test should be used to exclude IFI rather than for diagnosis in these patients.
对于侵袭性真菌感染（IFI）低发人群，如接受抗霉菌预防治疗的血液病患者，β-D-葡聚糖（BDG）的诊断价值应重新评估。
我们回顾性分析了2017年1月至2019年8月在一家三级医院接受抗霉菌预防治疗的血液病患者的BDG检测结果。这些病例被分为真阳性（[TP]IFI且BDG阳性）、真阴性（[TN]无IFI且BDG阴性）、假阳性（[FP]无IFI且BDG阳性）、假阴性（[FN]有IFI且BDG阴性）以及无法评估。
共分析了203例病例：101例（49.8%）来自干细胞移植，89例（43.8%）来自诱导化疗，13例（6.4%）来自移植物抗宿主病治疗。有62例无法评估。在141例可评估病例中，有8例（5.7%）可能/确诊为IFI。真阳性、TN、FP和FN病例分别为4例（2.
