Zhao Ying, Wang Ze-Yu, Zhang Xue-Dong, Wang Yao, Yang Wen-Hang, Xu Ying-Chun
Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.
Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases, Beijing 100730, China.
Diagnostics (Basel). 2022 Jun 14;12(6):1461. doi: 10.3390/diagnostics12061461.
This study aimed to assess the diagnostic values of peptidoglycan (PGN), lipopolysaccharide (LPS) and (1,3)-Beta-D-Glucan (BDG) in patients with suspected bloodstream infection. We collected 493 heparin anticoagulant samples from patients undergoing blood culture in Peking Union Medical College Hospital from November 2020 to March 2021. The PGN, LPS, and BDG in the plasma were detected using an automatic enzyme labeling analyzer, GLP-F300. The diagnostic efficacy for PGN, LPS, and BDG were assessed by calculating the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). This study validated that not only common bacteria and fungi, but also some rare bacteria and fungi, could be detected by testing the PGN, LPS, and BDG, in the plasma. The sensitivity, specificity, and total coincidence rate were 83.3%, 95.6%, and 94.5% for PGN; 77.9%, 95.1%, and 92.1% for LPS; and 83.8%, 96.9%, and 95.9% for BDG, respectively, which were consistent with the clinical diagnosis. The positive rates for PGN, LPS, and BDG and the multi-marker detection approach for PGN, LPS, and BDG individually were 11.16%, 17.65%, and 9.13%, and 32.86% significantly higher than that of the blood culture (p < 0.05). The AUC values for PGN, LPS, and BDG were 0.881 (0.814−0.948), 0.871 (0.816−0.925), and 0.897 (0.825−0.969), separately, which were higher than that of C-reactive protein (0.594 [0.530−0.659]) and procalcitonin (0.648 [0.587−0.708]). Plasma PGN, LPS, and BDG performs well in the early diagnosis of bloodstream infections caused by Gram-positive and Gram-negative bacterial and fungal pathogens.
本研究旨在评估肽聚糖（PGN）、脂多糖（LPS）和（1,3）-β-D-葡聚糖（BDG）对疑似血流感染患者的诊断价值。我们于2020年11月至2021年3月在北京协和医院收集了493例接受血培养患者的肝素抗凝样本。使用自动酶标分析仪GLP-F300检测血浆中的PGN、LPS和BDG。通过计算敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）来评估PGN、LPS和BDG的诊断效能。本研究证实，检测血浆中的PGN、LPS和BDG不仅可以检测常见的细菌和真菌，还可以检测一些罕见的细菌和真菌。PGN的敏感性、特异性和总符合率分别为83.3%、95.6%和94.5%；LPS分别为77.9%、95.1%和92.1%；BDG分别为83.8%、96.9%和95.9%，均与临床诊断相符。PGN、LPS和BDG的阳性率以及PGN、LPS和BDG单独的多标志物检测方法分别为11.16%、17.65%和9.13%，且显著高于血培养的阳性率（p<0.05）。PGN、LPS和BDG的AUC值分别为0.881（0.814−0.948）、0.871（0.816−0.925）和0.897（0.825−0.969），均高于C反应蛋白（0.594[0.530−0.659]）和降钙素原（0.648[0.587−0.708]）。血浆PGN、LPS和BDG在革兰氏阳性和革兰氏阴性细菌及真菌病原体引起的血流感染的早期诊断中表现良好。
