Detection of (1,3)-β-D-Glucan for the Diagnosis of Invasive Fungal Infection in Liver Transplant Recipients

被引：22
作者：
Levesque, Eric [1 ,2 ]
Rizk, Fadi [1 ]
Noorah, Zaid [1 ]
Ait-Ammar, Nawel [3 ,4 ]
Cordonnier-Jourdin, Catherine [5 ]
El Anbassi, Sarra [3 ]
Bonnal, Christine [3 ]
Azoulay, Daniel [6 ]
Merle, Jean-Claude [1 ]
Botterel, Francoise [3 ,4 ]
机构：
[1] Henri Mondor Hosp, AP HP, Dept Anaesthesia & Surg Intens Care Liver ICU, 51 Ave Marechal Lattre de Tassigny, F-94100 Creteil, France
[2] INSERM, Unit U955, F-94100 Creteil, France
[3] Henri Mondor Hosp, AP HP, Microbiol Dept, Mycol Unit,DHU Virus Immunite Canc VIC, F-94100 Creteil, France
[4] EA Dynamyc Univ Paris Est Creteil UPEC, ENVA, Fac Med Creteil, 8 Rue Gen Sarrail, F-94010 Creteil, France
[5] Henri Mondor Hosp, AP HP, Pharm Unit, 51 Ave Marechal Lattre de Tassigny, F-94010 Creteil, France
[6] Henri Mondor Hosp, AP HP, Digest Surg & Liver Transplant Unit, F-94100 Creteil, France
来源：
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES | 2017年 / 18卷 / 04期
关键词：
(1,3)-beta-D-glucan; invasive fungal infection; liver transplantation; invasive pulmonary aspergillosis; invasive candidiasis; BETA-D-GLUCAN; HEMATOLOGICAL MALIGNANCIES; SERUM 1,3-BETA-D-GLUCAN; METAANALYSIS; CANDIDIASIS; PROPHYLAXIS; ASSAY; ASPERGILLOSIS; FLUCONAZOLE; PERFORMANCE;
D O I：
10.3390/ijms18040862
中图分类号：
Q5 [生物化学]; Q7 [分子生物学];
学科分类号：
071010 ; 081704 ;
摘要：
Invasive fungal infections (IFI) are complications after liver transplantation involving high morbidity and mortality. (1,3)-beta-D-glucan (BG) is a biomarker for IFI, but its utility remains uncertain. This study was designed to evaluate the impact of BG following their diagnosis. Between January 2013 and May 2016, 271 liver transplants were performed in our institution. Serum samples were tested for BG (Fungitell (R) Associates Cape Code Inc., Falmouth, MA, USA) at least weekly between liver transplantation and the discharge of patients. Nineteen patients (7%) were diagnosed with IFI, including 13 cases of invasive candidiasis (IC), eight cases of invasive pulmonary aspergillosis, and one case of septic arthritis due to Scedosporium apiospernum. Using a single BG sample for the primary analysis of IFI, 95% (21/22) of the subjects had positive BG (>80 pg/mL) at the time of IFI diagnosis. The area under the ROC curves to predict IFI was 0.78 (95% CI: 0.73-0.83). The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of BG for IFI were 75% (95% CI: 65-83), 65% (62-68), 17% (13-21), and 96% (94-97), respectively. Based on their high NPV, the BG test appears to constitute a good biomarker to rule out a diagnosis of IFI.
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页数：13
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