Lower sensitivity of serum (1,3)-β-d-glucan for the diagnosis of candidaemia due to Candida parapsilosis

The aim of this study was to evaluate the sensitivity and the levels of 1,3-β-d-glucan (BDG) among patients with candidaemia due to different Candida species. Retrospective study of all patients who had a single-species candidaemia and BDG testing performed within 48 h from the onset of candidaemia...

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Bibliographic Details
Published in:Clinical microbiology and infection 2016-07, Vol.22 (7), p.646.e5-646.e8
Main Authors: Mikulska, M., Giacobbe, D.R., Furfaro, E., Mesini, A., Marchese, A., Del Bono, V., Viscoli, C.
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
beta-Glucans - blood
Candida - classification
Candida - isolation & purification
Candida parapsilosis
Candidemia - diagnosis
Candidemia - microbiology
Diagnostic Tests, Routine - methods
Female
Fungitell
Glucan
Humans
Male
Middle Aged
Non-albicans
Retrospective Studies
Sensitivity and Specificity
Serum - chemistry
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Summary:The aim of this study was to evaluate the sensitivity and the levels of 1,3-β-d-glucan (BDG) among patients with candidaemia due to different Candida species. Retrospective study of all patients who had a single-species candidaemia and BDG testing performed within 48 h from the onset of candidaemia during 2009–2015 was performed. Factors influencing the sensitivity of BDG, including the presence of a central venous catheter, antifungal therapy and Candida species, were analysed in univariate and multivariate models. In all, 107 patients with the following Candida distribution were included: 46 (43%) Candida albicans, 37 (35%) Candida parapsilosis, and 24 (22%) other species. BDG sensitivity and levels were the highest in C. albicans candidaemia and lowest for C. parapsilosis (respectively, 72% and 410 pg/mL for C. albicans, 41% and 39 pg/mL for C. parapsilosis, and 63% and 149 pg/mL for other species; p 0.015 and p 0.003). In multivariate analysis, Candida species (parapsilosis versus others) was the only factor influencing the sensitivity of BDG (OR 0.3, 95% CI 0.1–0.7, p 0.006). The sensitivity of BDG in candidaemia seems highly dependent on the fungal species, with the lowest being for C. parapsilosis.
ISSN:1198-743X
1469-0691
DOI:10.1016/j.cmi.2016.05.020