Significance of G Test [(1-3)-β-D-Glucan Assay] in the Diagnosis and Guidance of Clinical Medication of Invasive Fungal Infection
American Journal of Internal Medicine
Volume 7, Issue 2, March 2019, Pages: 46-50
Received: Apr. 13, 2019; Accepted: May 21, 2019; Published: Jun. 11, 2019
Views 182      Downloads 25
Authors
Lianfang Xue, Department of Pharmacy, The First Affiliated Hospital of Jinan University, Guangzhou, China
Suishan Qiu, Department of Pharmacy, The First Affiliated Hospital of Jinan University, Guangzhou, China
Guangchao Yu, Department of Laboratory, The First Affiliated Hospital of Jinan University, Guangzhou, China
Qin-Ai Zhu, Department of Laboratory, The First Affiliated Hospital of Jinan University, Guangzhou, China
Shasha Li, Department of Pharmacy, The First Affiliated Hospital of Jinan University, Guangzhou, China
Hui Liu, Department of Pharmacy, The First Affiliated Hospital of Jinan University, Guangzhou, China
Yuping Wang, Department of Pharmacy, The First Affiliated Hospital of Jinan University, Guangzhou, China
Fengtian Ouyang, College of Pharmacy, Jinan University, Guangzhou, China
Wenyu Gong, Department of Nephrology, The First Affiliated Hospital of Jinan University, Guangzhou, China
Article Tools
Follow on us
Abstract
Objective: G test [(1-3) -β-D-glucan assay] was a novel texting method for invasive fungal infection (IFI). The study evaluated the diagnostic value of G test for IFI by comparing G test with fungal culture method,and analyze the guiding significance of G test and fungal culture in clinical medication. Methods: 373 inpatients with suspected IFI in the first affiliated hospital of Jinan university from January to December 2017 were retrospectively analyzed. G test and fungal culture results were collected, and their positive rate, sensitivity, specificity, positive and negative predictive values were calculated. The value and rationality of G test for clinical diagnosis of IFI was evaluated by taking the relief and cure of infection symptoms of patients as clinical effective criteria. Results: Among 373 suspected IFI patients, the positive rate of G experiment was 39.95%, higher than that of fungus culture (28.95%, P<0.001). The positive rate of combined G test and fungal culture was 43.70%. To evaluate the consistency of G test with fungal culture method, κ value was 0.596 (P<0.001). When positive fungal culture was used as the criterion for the diagnosis of IFI, the sensitivity, specificity, positive predictive value and negative predictive value of G test for the diagnosis of IFI were 87.04%, 79.25%, 63.09% and 93.75%, respectively. All 373 patients with IFI received antifungal therapy, and the effective rate of the both methods positive group was 72.34%, higher than 42.86% in the only fungal culture positive group (P=0.033) and 30.48% in the both methods negative group (P<0.001). The effective rate of the only G test positive group was 58.18%, higher than that of the both methods negative group (30.48%, P<0.001). There was no significant difference in the therapeutic efficiency between the only G test positive group and the only fungal culture positive group (P=0.303). Conclusion: G test was an effective diagnostic method of IFI, and combined with fungal culture could improve its positive rate and have a higher guiding value for clinical medication.
Keywords
Invasive Fungal Infection, G Test, (1-3)-β-D-Glucan, Diagnostic Value, Fungal Culture
To cite this article
Lianfang Xue, Suishan Qiu, Guangchao Yu, Qin-Ai Zhu, Shasha Li, Hui Liu, Yuping Wang, Fengtian Ouyang, Wenyu Gong, Significance of G Test [(1-3)-β-D-Glucan Assay] in the Diagnosis and Guidance of Clinical Medication of Invasive Fungal Infection, American Journal of Internal Medicine. Vol. 7, No. 2, 2019, pp. 46-50. doi: 10.11648/j.ajim.20190702.15
Copyright
Copyright © 2019 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
[1]
Mikulska, M., E. Furfaro and C. Viscoli, Non-cultural methods for the diagnosis of invasive fungal disease. Expert Rev Anti Infect Ther, 2015. 13(1): p. 103-17.
[2]
Groll, A. H. and J. Ritter, [Diagnosis and management of fungal infections and pneumocystis pneumonitis in pediatric cancer patients]. Klin Padiatr, 2005. 217 Suppl 1: p. S37-66.
[3]
Denning, D. W. and P. Munoz, Advances in invasive fungal infection and antifungal therapy: Introduction. Clin Microbiol Infect, 2001. 7 Suppl 2: p. vi.
[4]
Pickering, J. W., et al., Evaluation of a (1->3)-beta-D-glucan assay for diagnosis of invasive fungal infections. J Clin Microbiol, 2005. 43(12): p. 5957-62.
[5]
Schuetz, A. N., Invasive fungal infections: biomarkers and molecular approaches to diagnosis. Clinics in laboratory medicine, 2013. 33(3): p. 505.
[6]
Montagna, M. T., et al., Epidemiology of invasive fungal infections in the intensive care unit: results of a multicenter Italian survey (AURORA Project). Infection, 2013. 41(3): p. 645-53.
[7]
Kontoyiannis, D. P., A clinical perspective for the management of invasive fungal infections: focus on IDSA guidelines. Infectious Diseases Society of America. Pharmacotherapy, 2001. 21(8 Pt 2): p. 175S-187S.
[8]
Murri, R., et al., Performance evaluation of the (1, 3)-beta-D-glucan detection assay in non-intensive care unit adult patients. Infect Drug Resist, 2019. 12: p. 19-24.
[9]
Yoshida, K., H. Shoji and T. Takuma, Clinical viability of fungitell, a new (1-3)-β-D-glucan measurement kit, for diagnosis of invasive fungal infection, and comparison with other kits available in Japan. J Infect Chemother., 2011. 17(4): p. 473-477.
[10]
Giacobbe, D. R., et al., Combined use of serum (1, 3)-beta-D-glucan and procalcitonin for the early differential diagnosis between candidaemia and bacteraemia in intensive care units. Crit Care, 2017. 21(1): p. 176.
[11]
He S, et al., A systematic review and meta-analysis of diagnostic accuracy of serum 1, 3-β-D-glucan for invasive fungal infection: Focus on cutoff levels. J Microbiol Immunol Infect., 2014. 48(4): p. 351-361.
[12]
Shabaan AE, E. L. E. W., Role of serum (1, 3)-β-d-glucan assay in early diagnosis of invasive fungal infections in a neonatal intensive care unit. J Pediatr (Rio J). 2018 Sep - Oct; 94(5):559-565.
[13]
Nucci, M., et al., Performance of 1, 3-beta-D-glucan in the diagnosis and monitoring of invasive fusariosis. Mycoses, 2019.
[14]
Hachem, R. Y., et al., Utility of galactomannan enzyme immunoassay and (1, 3) beta-D-glucan in diagnosis of invasive fungal infections: low sensitivity for Aspergillus fumigatus infection in hematologic malignancy patients. J Clin Microbiol, 2009. 47(1): p. 129-33.
[15]
Tran T, B. S., Application of the 1, 3-b-D-Glucan (Fungitell) Assay in the Diagnosis of Invasive Fungal Infections. Arch Pathol Lab Med. 2016 Feb; 140(2):181-5..
[16]
Trager, J., et al., Serum (1-->3)-beta-D-glucan and galactomannan levels in patients with cystic fibrosis: a retrospective cohort study. BMC Pulm Med, 2018. 18(1): p. 52.
ADDRESS
Science Publishing Group
1 Rockefeller Plaza,
10th and 11th Floors,
New York, NY 10020
U.S.A.
Tel: (001)347-983-5186