1,3-Beta-D-glucan antigenemia for early diagnosis of invasive fungal infections in neutropenic patients with acute leukemia.

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Serval ID
serval:BIB_C3751492AAD0
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
1,3-Beta-D-glucan antigenemia for early diagnosis of invasive fungal infections in neutropenic patients with acute leukemia.
Journal
Clinical Infectious Diseases
Author(s)
Senn L., Robinson J.O., Schmidt S., Knaup M., Asahi N., Satomura S., Matsuura S., Duvoisin B., Bille J., Calandra T., Marchetti O.
ISSN
1537-6591
Publication state
Published
Issued date
03/2008
Peer-reviewed
Oui
Volume
46
Number
6
Pages
878-885
Language
english
Abstract
BACKGROUND: Invasive fungal infections (IFIs) are life-threatening complications in neutropenic patients with hematological malignancies. Because early diagnosis of IFI is difficult, new noninvasive, culture-independent diagnostic tools are needed to improve clinical management. Recent studies have reported that detection of 1,3-beta-D-glucan (BG) antigenemia may be useful for diagnosis of IFI. The aim of the present prospective study was to evaluate the usefulness of monitoring BG in patients undergoing chemotherapy for acute leukemia. METHODS: BG antigenemia was measured by a colorimetric assay twice weekly in the absence of fever and daily in the presence of fever. IFIs were classified according to the criteria of the European Organization for Research and Treatment of Cancer/Mycoses Study Group. RESULTS: During 190 consecutive neutropenic episodes (median duration, 22 days; range, 7-113 days) in 95 patients, 30 proven or probable IFIs (13 aspergillosis, 15 candidiasis, and 2 mixed IFIs) were diagnosed. Sensitivity, specificity, positive predictive value, negative predictive value, and efficiency of 2 consecutive BG values > or =7 pg/mL for diagnosis of proven or probable IFI was 0.63 (95% confidence interval, 0.44-0.79), 0.96 (95% confidence interval, 0.89-0.98), 0.79 (95% confidence interval, 0.57-0.92), 0.91 (95% confidence interval, 0.84-0.95), and 0.89, respectively. The time interval between onset of fever as first sign of IFI and BG antigenemia was significantly shorter than the time to diagnosis of IFI by clinical, microbiological, radiological, and/or histopathological criteria (P < .001). BG values >50 pg/mL were observed in only 2 patients, both of whom experienced failure of antifungal therapy. CONCLUSION: Monitoring of BG antigenemia is a useful noninvasive method for early diagnosis of IFI in patients with acute leukemia.
Keywords
Adult, Aged, Antigens, Fungal, Aspergillosis, Candidiasis, Female, Fungemia, Humans, Leukemia, Myeloid, Acute, Male, Middle Aged, Mycoses, Neutropenia, Precursor Cell Lymphoblastic Leukemia-Lymphoma, Predictive Value of Tests, Sensitivity and Specificity, beta-Glucans
Pubmed
Web of science
Open Access
Yes
Create date
11/04/2008 11:40
Last modification date
14/02/2022 7:57
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