TY - JOUR A1 - Forster, Johannes A1 - Dichtl, Karl A1 - Wagener, Johannes T1 - Lower beta‐1,3‐D‐glucan testing cut‐offs increase sensitivity for non‐albicans Candida species bloodstream infections JF - Mycoses N2 - Purpose Fungal biomarkers support early diagnosis of invasive fungal infections. In this study, we evaluated the impact of a recent update to the manufacturer‐recommended cut‐off for beta‐1,3‐D‐glucan (BDG) testing (Fujifilm Wako BDG assay) on sensitivity and specificity for the detection of candidemia. Additionally, we compared the performance with tests for Candida antigen (Ag by Serion ELISA antigen Candida, Virion\Serion) and anti‐mannan antibodies (Ab by Hemkit Candida IHA, Ravo Diagnostika). Methods Sera of 82 patients with candidemia, which were sampled with a maximum distance of ±14 days from the date of sampling of the corresponding positive blood cultures, were retrospectively analysed for BDG, Ag and Ab. Results of BDG testing were compared with results from sera of 129 patients with candidemia from a different hospital. Results Sensitivity of BDG testing (47%) was higher than for Ag (17%) or Ab (20%). By combining Ag and Ab testing, sensitivity was raised to 32%. Lowering the cut‐off of BDG from 11 pg/ml to the newly recommended cut‐off of 7 pg/ml resulted in a significant increase in sensitivity (47% vs 58%, p = .01 and 63% vs 71% p < .01). At both centres, the increase was significant in NAC but not in C. albicans candidemia. No significant effects on specificity were observed. Conclusion BDG testing outperformed Ag and Ab testing and its combination. Lowering the BDG cut‐off had no significant impact on specificity. The increase in sensitivity can be mainly attributed to a gain in sensitivity for non‐albicans Candida species bloodstream infections. KW - antigen testing KW - BDG KW - beta‐d‐glucan KW - bloodstream infection KW - candidemia KW - mannan Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-276515 VL - 65 IS - 5 SP - 500 EP - 507 ER - TY - JOUR A1 - Dichtl, Karl A1 - Koc, Özlem A1 - Forster, Johannes A1 - Scharf, Christina A1 - Suerbaum, Sebastian A1 - Andrassy, Joachim A1 - Wagener, Johannes A1 - Schroeder, Ines T1 - An invasive infection caused by the thermophilic mold Talaromyces thermophilus JF - Infection N2 - Background Increasing incidence of invasive infections caused by rare fungi was observed over the recent years. Case Here, we describe the first reported case of an infection caused by the thermophilic mold Talaromyces thermophilus. Cultivation and, hence, identification of this fastidious organism is challenging since standard incubation conditions are not sufficient. Retrospective analysis of patient samples and in vitro experiments demonstrated that testing for fungal antigens, i.e., the cell wall components galactomannan and β-1,3-D-glucan, is a promising tool. KW - Talaromyces KW - invasive fungal infection KW - thermophile KW - antigen testing KW - serology Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-308970 SN - 0300-8126 SN - 1439-0973 VL - 49 IS - 6 ER -