Document Detail


Difficulties in using 1,3-{beta}-D-glucan as the screening test for the early diagnosis of invasive fungal infections in patients with haematological malignancies--high frequency of false-positive results and their analysis.
MedLine Citation:
PMID:  20488937     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We have evaluated the contribution of the 1,3-beta-d-glucan (BG) assay for the screening of invasive fungal infections (IFIs) in patients with haematological 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 (1x >60 pg ml(-1), 1x >80 pg ml(-1), 2x >60 pg ml(-1) or 2x >80 pg ml(-1)) the sensitivity and specificity were 89, 89, 67 and 44 %, and 20, 48, 33 and 56 %, respectively. 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 an extremely low positive predictive value (10 to 12 %). We have analysed mucositis, candida colonization, bacteraemia, use of 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, BG detection has a limited usefulness as a screening method for IFIs in patients with haematological malignancies.
Authors:
Zdenek Racil; Iva Kocmanova; Martina Lengerova; Barbora Weinbergerova; Lucie Buresova; Martina Toskova; Jana Winterova; Shira Timilsina; Isa Rodriguez; Jiri Mayer
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-05-20
Journal Detail:
Title:  Journal of medical microbiology     Volume:  59     ISSN:  1473-5644     ISO Abbreviation:  J. Med. Microbiol.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-19     Completed Date:  2010-09-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0224131     Medline TA:  J Med Microbiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  1016-22     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine Hemato-Oncology, Masaryk University and University Hospital Brno, Brno, Czech Republic.
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MeSH Terms
Descriptor/Qualifier:
Antineoplastic Agents / adverse effects*,  therapeutic use
Female
Hematologic Neoplasms / complications*,  drug therapy*
Humans
Immunoassay
Immunocompromised Host
Male
Mycoses / blood,  diagnosis*,  immunology
Opportunistic Infections / chemically induced*,  diagnosis
Predictive Value of Tests
Sensitivity and Specificity
beta-Glucans / blood*
Chemical
Reg. No./Substance:
0/Antineoplastic Agents; 0/beta-Glucans; 9051-97-2/beta-1,3-glucan

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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