Detecting Invasive Fungal Disease in Surgical Patients: Utility of the (1→3)- β-D-Glucan Assay

被引：3

作者：

Skubic, Jeffrey ^{[1
]}

Taghavi, Sharven ^{[2
]}

Castillo-Angeles, Manuel ^{[3
]}

Ramsis, Ramsis ^{[4
]}

Salim, Ali ^{[3
]}

Askari, Reza ^{[3
]}

机构：

[1] Univ Texas Rio Grande Valley, Doctors Hosp Renaissance, Dept Surg, Edinburg, TX USA

[2] Tulane Univ, Sch Med, Div Trauma & Crit Care, 1430 Tulane Ave, New Orleans, LA 70112 USA

[3] Brigham & Womens Hosp, Div Trauma Burn & Surg Crit Care, 75 Francis St, Boston, MA 02115 USA

[4] Meharry Med Coll, Nashville, TN 37208 USA

来源：

SURGICAL INFECTIONS | 2020年 / 21卷 / 05期

关键词：

beta-D-glucan assay; invasive fungemia; surgical patients; INTENSIVE-CARE-UNIT; CELL TRANSPLANT RECIPIENTS; INFECTIONS; DIAGNOSIS; CANDIDEMIA;

D O I：

10.1089/sur.2019.247

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

Background: The specificity and sensitivity of the (1 -> 3)-beta-D-glucan (BDG) assay in surgical patients needs further investigation. We hypothesized that the BDG assay would have lower sensitivity/specificity compared with that of medical patients. Methods: We reviewed patients who had undergone laparotomy, gastrectomy, hepatectomy, or colectomy and had a BDG assay post-operatively. Results: A total of 71 patients met study criteria. There were 29 (40.8%) who had proven/probable invasive fungal infection. Sensitivity for BDG level >= 80 diagnosed within one week of the assay draw was 77.3% (95% confidence interval [CI], 54.6-92.2%), and specificity was 44.9% (95% CI, 30.7-59.8). The positive predictive value was 38.6% (95% CI, 31.0-46.9%), and negative predictive value was 82.5% (95% CI, 65.7-91.0%). A BDG assay result of 149 pg/mL had a classification rate of 63.4%. Therefore, a BDG assay result >= 150 pg/mL has a sensitivity of 78.6% and a specificity of 41.4%. Conclusion: A BDG assay can be useful for ruling out invasive fungemia in post-operative patients.

引用

页码：461 / 464

页数：4

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