Abstract
Objective: To evaluate the diagnostic value of (1 - 3)-β-D glucan and mannan assay for invasive candidiasis. Methods: A retrospective study was conducted on 32 cases in the disease group (18 proven invasive candidiasis and 14 probable invasive candidiasis) and 48 cases in the control group. The subjects were recruited from January 2018 to March 2019 in Clinical Laboratory of Hainan General Hospital. All subjects were detected by (1 - 3)-β-D glucan and mannan assay. Results: The mean concentration of (1 - 3)-β-D glucan in the disease group was 97.45 (43.23, 224.35) pg/ml and it was significantly higher than the mean concentration of the control group which was 49.85(41.91, 56.07) pg/ml (P = 0.005). The mean concentration of mannan in the disease group and the control group were 161.36 (34.96, 224.49) pg/ml and 25.80 (25.00, 29.31) pg/ml, respectively, which were significantly different (P β-D glucan assay were 59.38%, 89.58%, 79.17%, 76.79%, respectively. The sensitivity, specificity, positive predictive value and negative predictive value of mannan assay were 65.63%, 95.83%, 91.30%, 80.70%, respectively. The sensitivity, specificity, positive predictive value and negative predictive value of combination of two types of assays were 81.25%, 85.42%, 78.79% and 87.23%, respectively. Conclusions: Combination of (1 - 3)-β-D glucan and mannan assay can improve diagnostic specificity and it has essential clinical diagnostic value for invasive candidiasis.
Highlights
Invasive candidiasis usually occurs in immunocompromised patients, with a prevalence of 2.1 - 21/100,000 and a fatality rate of 40% - 60%
To evaluate the diagnostic value of (1 - 3)-β-D glucan and mannan assay for invasive candidiasis
Candida albicans colonized in the intestinal cavity breaks through the intestinal mucosal barrier and invades into the blood, causing Candidaemia and invasive candidiasis
Summary
Invasive candidiasis usually occurs in immunocompromised patients, with a prevalence of 2.1 - 21/100,000 and a fatality rate of 40% - 60%. Candida albicans colonized in the intestinal cavity breaks through the intestinal mucosal barrier and invades into the blood, causing Candidaemia and invasive candidiasis. (1 - 3)-β-D glucan exists in fungal cell wall [5], using as a detection marker for a variety of pathogenic fungal infections. Jiang et al demonstrate that compared with the bacterial infection group, the Candida colonization group and the control group, the positive rate of mannan group was significantly higher in the invasive candidiasis [9]. When mannan detection using enzyme-linked immunoassay technology, it can improve the diagnostic performance of invasive fungal diseases [10]. This study explored the clinical diagnostic value of combined detection of (1 - 3)-β-D glucan and Candida mannan in invasive candidiasis through a retrospective study
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