Diagnostic performance of the (1-3)-ß-d-glucan assay in patients with different risks for invasive fungal diseases.
Med Mycol
; 62(8)2024 Aug 02.
Article
en En
| MEDLINE
| ID: mdl-39030069
ABSTRACT
We evaluated the diagnostic performance of the ß-d-glucan (BDG) test (Beijing Gold Mountain River Tech) in diagnosing invasive fungal disease (IFD) and its variations among patients with different risks. Patients ≥18 years old who underwent a serum BDG test (positive cutoff value >80 pg/ml) from April 2017 through May 2018 were collected consecutively. Patients were classified into three groups group 1, patients with host factors as defined by the prior 2008 European Organization for Research and Treatment (EORTC) criteria; group 2, those with extended host factors in 2020 EORTC criteria; and group 3, those without any risk factor mentioned in the criteria. IFD was defined by 2020 EORTC criteria, but BDG was not considered. Diagnostic performance of the serum BDG test was measured by the area under the curve (AUC) of the receiver-operating characteristic curve. Among 469 patients, 15.4% (72/469) were diagnosed with IFD (48/191 [25.1%], 14/144 [9.7%], and 10/134 [7.5%] in groups 1, 2, and 3, respectively). The BDG assay showed fair performance (AUC 0.748 [95% CI 0.688-0.810]). Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 77.8%, 60.7%, 26.4%, and 93.8%, respectively. PPV was higher in group 1, and NPV was higher in group 3. Additionally, diagnostic odds ratios were 6.73, 2.88, and 5.92 in groups 1, 2, and 3. Immunosuppressant use, non-IFD/Candida colonization, and central venous catheter were associated with false positivity. Clinicians should cautiously interpret the BDG assay, considering the various diagnostic performances depending on the different levels of risk.
We evaluated the diagnostic performance of the serum ß-d-glucan test in patients with varying risks for invasive fungal diseases. The test showed acceptable performance, but its predictive values differed among risk groups, highlighting the need for tailored interpretation.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Curva ROC
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Beta-Glucanos
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Infecciones Fúngicas Invasoras
Límite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Med Mycol
Asunto de la revista:
MEDICINA VETERINARIA
/
MICROBIOLOGIA
Año:
2024
Tipo del documento:
Article
País de afiliación:
Corea del Sur
Pais de publicación:
Reino Unido