Lower beta‐1,3‐D‐glucan testing cut‐offs increase sensitivity for non‐albicans Candida species bloodstream infections
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- 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 withPurpose
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.…
| Autor(en): | Johannes Forster, Karl Dichtl, Johannes Wagener |
|---|---|
| URN: | urn:nbn:de:bvb:20-opus-276515 |
| Dokumentart: | Artikel / Aufsatz in einer Zeitschrift |
| Institute der Universität: | Medizinische Fakultät / Institut für Hygiene und Mikrobiologie |
| Sprache der Veröffentlichung: | Englisch |
| Titel des übergeordneten Werkes / der Zeitschrift (Englisch): | Mycoses |
| Erscheinungsjahr: | 2022 |
| Band / Jahrgang: | 65 |
| Heft / Ausgabe: | 5 |
| Erste Seite: | 500 |
| Letzte Seite: | 507 |
| Originalveröffentlichung / Quelle: | Mycoses 2022, 65(5):500-507. DOI: 10.1111/myc.13421 |
| DOI: | https://doi.org/10.1111/myc.13421 |
| Allgemeine fachliche Zuordnung (DDC-Klassifikation): | 5 Naturwissenschaften und Mathematik / 57 Biowissenschaften; Biologie / 570 Biowissenschaften; Biologie |
| Freie Schlagwort(e): | BDG; antigen testing; beta‐d‐glucan; bloodstream infection; candidemia; mannan |
| Datum der Freischaltung: | 03.07.2023 |
| Lizenz (Deutsch): |  CC BY: Creative-Commons-Lizenz: Namensnennung 4.0 International |