Institute of Microbiology, Department of Laboratories, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland.
University of Lille, INSERM U1285, CHU Lille, Pôle de Médecine Intensive/Réanimation, CNRS, UMR 8576 - UGSF - Unité de Glycobiologie Structurale et Fonctionnelle, Lille, France.
J Clin Microbiol. 2023 Feb 22;61(2):e0169122. doi: 10.1128/jcm.01691-22. Epub 2023 Jan 26.
The (1→3)-β-d-glucan (BDG) is a marker of invasive fungal infection that can be detected in serum by different commercial kits. In this study, we compared the performance of the Fungitell assay (FA), the Fungitell STAT assay (STAT), and the Wako β-glucan test (WA) for the diagnosis of invasive candidiasis (IC) in the intensive care unit (ICU). Patients for whom at least one BDG testing was required for a clinical suspicion of IC were retrospectively enrolled. A total of 85 serum samples from 56 patients were tested by the three BDG tests. The rate of IC was 23% (13/56) with a predominance of noncandidemic (intra-abdominal) IC. STAT and WA results exhibited overall good correlation with those obtained by FA (Spearman's coefficient = 0.90 and = 0.89, respectively). For the recommended cutoffs of positivity, sensitivity and specificity for IC diagnosis were 77%/51% (FA, 80 pg/mL), 69%/53% (STAT, ratio 1.2), and 54%/65% (WA, 7 pg/mL), respectively. Optimal performance was obtained at 50 pg/mL (FA), ratio 1.3 (STAT), and 3.3 pg/mL (WA) with sensitivity/specificity of 85%/51%, 69%/57%, and 77%/58%, respectively. Overall, the three BDG tests showed comparable but limited performance in this setting with positive and negative predictive values for an estimated IC prevalence of 20% that were in the range of 30 to 35% and 85 to 95%, respectively.
(1→3)-β-D-葡聚糖(BDG)是一种侵袭性真菌感染的标志物,可以通过不同的商业试剂盒在血清中检测到。在这项研究中,我们比较了 Fungitell 检测法(FA)、Fungitell STAT 检测法(STAT)和 Wako β-葡聚糖检测法(WA)在诊断重症监护病房(ICU)侵袭性念珠菌病(IC)中的性能。对至少有一个 BDG 检测结果提示临床疑似 IC 的患者进行了回顾性入组。对 56 名患者的 85 份血清样本进行了三项 BDG 检测。IC 的发生率为 23%(13/56),以非念珠菌性(腹腔内)IC 为主。STAT 和 WA 结果与 FA 结果总体上具有良好的相关性(Spearman 相关系数分别为 0.90 和 0.89)。对于阳性结果的推荐截断值,用于 IC 诊断的敏感性和特异性分别为 77%/51%(FA,80 pg/mL)、69%/53%(STAT,比值 1.2)和 54%/65%(WA,7 pg/mL)。在 FA 为 50 pg/mL、STAT 为 1.3、WA 为 3.3 时,最佳性能分别为 85%/51%、69%/57%和 77%/58%。总的来说,在这种情况下,这三种 BDG 检测方法的性能相当,但都有限,对于估计 20%的 IC 患病率,阳性和阴性预测值在 30%至 35%和 85%至 95%之间。
J Clin Microbiol. 2023-2-22
Intensive Care Med. 2015-7-2