Difficulties in using 1,3-ß-D glucan as the screening test for the early diagnosis of invasive fungal diseases in patients with hematological malignancies - high frequency of false positive results and their analysis.
| Authors | |
|---|---|
| Year of publication | 2010 |
| Type | Article in Periodical |
| Magazine / Source | Journal of Medical Microbiology |
| MU Faculty or unit | |
| Citation | |
| Doi | http://dx.doi.org/10.1099/jmm.0.019299-0 |
| Field | Oncology and hematology |
| Keywords | invasive fungal disease; glucan; false positive results |
| Description | We have evaluated the contribution of 1,3-ß-D-glucan (BG) assay for screening of invasive fungal diseases (IFI) in patients with hematological malignancies. Serum samples from patients at risk of IFI were collected twice a week and retrospectively tested using the BG assay. BG screening was performed on 1143 samples from 91 patients during 104 anticancer treatment cycles. Proven and probable cases of IFI occurred in 9 (8.7%) treatment cycles. Depending on the criterion of positivity used (1> 60 or 1> 80 pg/ml and 2> 60 or 2> 80 pg/ml) the sensitivity was 89%, 89%, 67% and 44%. Although the test was marked as positive in 82%, 68%, 54% and 45% of all the treatment cycles, in the majority of cases, these positivities were probably false. The major limit of the BG test was extremely low PPV (10% to 12%). We have analyzed mucositis, candida colonization, bacteremia, using antimicrobials, erythrocyte and thrombocyte filtered blood products, collecting tubes or sampling via venous catheters. Even though no factor is a major source of BG, it could at least partially influence BG assay performance. Thus, the BG detection has a limited usefulness as a screening method for invasive fungal infections in patients with hematological malignancies. |
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