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Combination of serum galactomannan with plasma 1,3-β-D glucan in diagnosis of invasive fungal infections

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Author:
No author available
Journal Title:
Chinese Journal of Clinical Infectious Diseases
Issue:
2
DOI:
10.3760/cma.j.issn.1674-2397.2014.02.007
Key Word:
真菌;β葡聚糖类;半乳甘露聚糖;感染;诊断;Fungi;Beta-glucans;Galactomannan;Infections;Diagnosis

Abstract: Objective To evaluate the combination of serum galactomannan test (GM test) with plasma 1,3-β-D-glucan test (G test) in diagnosis of invasive fungal infections (IFI).Methods A total of 261 patients with hematologic malignancies admitted in Zhejiang Provincial Hospital of Traditional Chinese Medicine from September 2012 to November 2013 were enrolled,including 1 patient with confirmed IFI,24 with clinically diagnosed IFI,50 with suspended IFI and 186 patients with excluded IFI.Serum galactomannan and plasma 1,3-β-D-glucan were detected with enzyme-linked immunosorbent assay (ELISA) and dynamic turbidimetric assay,respectively.Changes on aspergillus galactomannan antigen and 1,3-β-D glucan concentrations before and after treatment were observed.And chi-square test was used to compare sensitivities,specificities,negative predictive values and positive predictive values of GM test and G test and the combination of GM and G tests in diagnosing IFI.Results Within 261 patients,57 were positive in GM test,and 73 were positive in G test.The sensitivity,specificity,negative predictive value and positive predictive value of GM test were 92.0%,97.3%,82.1% and 98.9% ; Those of G test were 96.0%,89.8%,55.8% and 99.4% ; And those of GM combined with G test were 92.0%,97.8%,85.2% and 99.4%.Compared with G test,the specificity and positive predictive value were higher when GM combined with G test (x2 =10.399 and 6.393,P < 0.05).In those who responded to voriconazole treatment,serum GM test and plasma M test showed a decreased value after the treatment.C.onclusions GM and G tests are of value in diagnosis of IFI,and the combination of GM and G tests can improve the diagnostic specificity.Dynamic change of GM and G test values can reflect the therapeutic response.

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