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(1-3)-β-D-葡聚糖检测对预测念珠菌血症的临床灵敏度。

Clinical Sensitivity of the (1-3)-β-D-glucan Test for Predicting Candidemia.

机构信息

Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Department of Infectious Diseases, Kosin University Gospel Hospital, Busan, Korea.

出版信息

Ann Lab Med. 2023 Jul 1;43(4):381-385. doi: 10.3343/alm.2023.43.4.381. Epub 2023 Feb 24.

Abstract

The sensitivity of the (1-3)-β-D-glucan (BDG) diagnostic test for candidemia varies in different clinical settings, and its usefulness in early diagnosis of candidemia is suboptimal. We evaluated the sensitivity of the test for early candidemia prediction. All adult patients with culture-proven candidemia who underwent a serum Goldstream Fungus (1-3)-β-D-Glucan Test within seven days prior to candidemia onset at a tertiary referral hospital between January 2017 and May 2021 were included. Any-positive BDG results within seven days prior to candidemia onset were obtained in 38 out of 93 (40.9%) patients. The positive rate increased when the test was performed near the day of candidemia onset (=0.04) but reached only 52% on the day of candidemia onset. We observed no significant differences between BDG-positive and -negative groups in terms of underlying disease, risk factors for candidemia, clinical presentation, origin of candidemia, and 30-day mortality. was significantly associated with positive BDG results than with all-negative BDG results (=0.04). The Goldstream BDG test is unreliable for candidemia prediction because of its low sensitivity. Negative BDG results in patients with a high risk of invasive candidiasis should be interpreted with caution.

摘要

(1-3)-β-D-葡聚糖(BDG)诊断试验对念珠菌血症的敏感性在不同临床环境中有所差异,其在念珠菌血症早期诊断中的作用并不理想。我们评估了该试验对早期念珠菌血症预测的敏感性。所有在 2017 年 1 月至 2021 年 5 月期间于一家三级转诊医院,在念珠菌血症发病前七天内接受过血清 Goldstream 真菌(1-3)-β-D-葡聚糖试验且培养证实为念珠菌血症的成年患者均被纳入研究。在 93 例念珠菌血症患者中,有 38 例(40.9%)在念珠菌血症发病前七天内获得了任何阳性的 BDG 结果。当试验在念珠菌血症发病当天附近进行时,阳性率增加(=0.04),但在念珠菌血症发病当天仅达到 52%。BDG 阳性组和阴性组在基础疾病、念珠菌血症的危险因素、临床表现、念珠菌血症的来源和 30 天死亡率方面无显著差异。与所有阴性 BDG 结果相比,阳性 BDG 结果与阳性 BDG 结果显著相关(=0.04)。Goldstream BDG 试验对念珠菌血症的预测不可靠,因为其敏感性低。对于有侵袭性念珠菌病高危因素的患者,BDG 结果阴性应谨慎解读。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f2b2/9989527/8127bebfbe98/alm-43-4-381-f1.jpg

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