Evaluation on panfungal marker (1,3) Beta-glucan diagnosis of invasive infections with Candida species

Abstract

Introduction: Although blood culture is considered a gold standard in diagnosis of invasive infections, it is still not reliable and fast enough for diagnosis of candidemia. Determination of serum (1,3)--D-glucan is a highly sensitive and specific test for invasive mycosis, and could probably benefit patients with high risk for invasive infections with Candida species. Aim: the aim of this study was to prospectively evaluate the diagnostic performance of serum (1,3)--D-glucan BDG (Fungitell) assay, in comparison with blood culture, for diagnosis of invasive infections with Candida species. Material and methods: Blood and sera from 120 patients divided in 4 groups, hospitalized at the University clinics in Skopje, during a 2-year period, were investigated for invasive Candida infections. Blood was examined with conventional methods (automated BacT/Alert system, Gram stain and culture on fungal media). Identification of Candida species was performed with VITEK-2 system. Serum (1,3)--D-glucan was determined by means of Fungitell assay. Results: Positive blood culture was registered in 23.33%, 43.33%, 23.8% and in 3.33% sample only in groups I, II, III and IV, respectively. Positive findings with (1,3)--D-glucan Fungitell assay at the same time with blood culture were detected in 83.33%, 76.67%, 30% and 26.67% in groups I, II, III and IV respectively. The average concentration of BDG was highest in group I, followed by group II, group IV and group III. Conclusion: our results suggest that a positive (1,3)--D-glucan assay could be a superior test in addition to the blood culture for diagnosis of candidemia and highlights the value of this test as a diagnostic adjunct in the serodiagnosis of an invasive candidiasis.