用于改善念珠菌血症诊断的血清生物标志物评估

Evaluation of Serum Biomarkers for Improved Diagnosis of Candidemia.

作者信息

Kinet-Poleur Amélie, Deckers Corentin, Saad Albichr Imane, Bogaerts Pierre, Honoré Patrick M, Bulpa Pierre, Ausselet Nathalie, Foret Frederic, Kidd François, Huang Te-Din, Montesinos Isabel

机构信息

Laboratory Medicine-Microbiology, CHU UCL Namur, 5530 Yvoir, Belgium.

Intensive Care Unit, CHU UCL Namur, 5530 Yvoir, Belgium.

出版信息

J Fungi (Basel). 2025 Mar 15;11(3):224. doi: 10.3390/jof11030224.

DOI:10.3390/jof11030224

PMID:40137262

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11942904/

Abstract

BACKGROUND

Candidemia, associated with high morbidity and mortality, remains challenging to diagnose due to the limitations of blood cultures. Serological biomarkers offer faster detection, enabling earlier treatment and improving outcomes.

METHODS

This study, conducted at CHU UCL Namur (August 2023-January 2025), evaluated three diagnostic biomarkers for candidemia: CAGTA IgG VirClia Monotest, Wako β-D-glucan test, and CandId OLM RT-PCR. A total of 35 candidemia cases and 20 controls were included.

RESULTS

CAGTA IgG VirClia Monotest demonstrated low sensitivity (46%) and moderate specificity (75%). Both Wako β-D-glucan test and CandId OLM RT-PCR exhibited higher sensitivity (74% and 71%, respectively) and excellent specificity (100%). The combined use of Wako β-D-glucan test and CandId OLM RT-PCR further enhanced diagnostic performance, achieving 91% sensitivity and 100% specificity. Misidentification between and was observed with CandId PCR, underlining a potential limitation in species-level discrimination.

CONCLUSIONS

Both Wako β-D-glucan test and CandID OLM RT-PCR outperformed CAGTA IgG VirClia Monotest in diagnosing candidemia, and their combination significantly improved diagnostic accuracy, albeit at a higher cost. These findings highlight the potential of integrating multiple biomarkers into diagnostic workflows to optimize early detection, though further studies are needed to refine strategies and address challenges.

摘要

背景

念珠菌血症与高发病率和死亡率相关，由于血培养的局限性，其诊断仍然具有挑战性。血清生物标志物可实现更快的检测，从而能够更早进行治疗并改善治疗结果。

方法

本研究于那慕尔大学中心医院进行（2023年8月至2025年1月），评估了三种念珠菌血症诊断生物标志物：CAGTA IgG VirClia Monotest、和光β-D-葡聚糖检测以及CandId OLM RT-PCR。共纳入35例念珠菌血症病例和20例对照。

结果

CAGTA IgG VirClia Monotest敏感性较低（46%），特异性中等（75%）。和光β-D-葡聚糖检测及CandId OLM RT-PCR均表现出较高的敏感性（分别为74%和71%）和出色的特异性（100%）。联合使用和光β-D-葡聚糖检测及CandId OLM RT-PCR进一步提高了诊断性能，敏感性达91%，特异性达100%。在CandId PCR检测中观察到与之间存在误判，这凸显了在种属水平鉴别方面的潜在局限性。