Beta-D-glucan as a diagnostic adjunct for invasive fungal infections: validation, cutoff development, and performance in patients with acute myelogenous leukemia and myelodysplastic syndrome

Clin Infect Dis. 2004 Jul 15;39(2):199-205. doi: 10.1086/421944. Epub 2004 Jun 28.

Abstract

The Glucatell (1-->3)- beta-D-glucan (BG) detection assay (Associates of Cape Cod) was studied as a diagnostic adjunct for invasive fungal infections (IFIs). On the basis of findings from a preliminary study of 30 candidemic subjects and 30 healthy adults, a serum BG level of >or=60 pg/mL was chosen as the cutoff. Testing was performed with serial serum samples obtained from 283 subjects with acute myeloid leukemia or myelodysplastic syndrome who were receiving antifungal prophylaxis. At least 1 serum sample was positive for BG at a median of 10 days before the clinical diagnosis in 100% of subjects with a proven or probable IFI. IFIs included candidiasis, fusariosis, trichosporonosis, and aspergillosis. Absence of a positive BG finding had a 100% negative predictive value, and the specificity of the test was 90% for a single positive test result and >or=96% for >or=2 sequential positive results. The Glucatell serum BG detection assay is highly sensitive and specific as a diagnostic adjunct for IFI.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Adult
  • Candidiasis / blood
  • Fungemia / blood
  • Humans
  • Leukemia, Myeloid, Acute / blood
  • Leukemia, Myeloid, Acute / complications*
  • Limulus Test
  • Mycoses / blood
  • Mycoses / complications
  • Mycoses / diagnosis*
  • Myelodysplastic Syndromes / blood
  • Myelodysplastic Syndromes / complications*
  • Neutropenia / blood
  • Neutropenia / complications
  • Polysaccharides / blood
  • Predictive Value of Tests
  • Proteoglycans
  • Reagent Kits, Diagnostic
  • Sensitivity and Specificity
  • beta-Glucans / blood*

Substances

  • Polysaccharides
  • Proteoglycans
  • Reagent Kits, Diagnostic
  • beta-Glucans
  • polysaccharide-K