Detection of (1,3)-β-D-glucan for diagnosis of invasive fungal infection in premature infants

Abstract

Objective To evaluate the diagnostic value of (1, 3)-β-D-glucan assay (G test) in the plasma of premature infants with invasive fungal infection (IFI) and determinate the best diagnostic value of G test. Methods The premature infants who were at risk of IFI from NICU were enrolled in Shengjing Hospital of China Medical University from July 2010 to September 2011. The concentration of (1, 3)-β-D-glucan were detected by GKT-5MSet microbial dynamic detection system, and the fungal and bacterial culture were performed in the same samples of blood. We used to perform statistic analysis for sensitivity, specificity, positive predictive value and negative predictive value at different cutoff values, and draw receiver operating characteristic curve for G test. Results Forty-four infants were eligible for the study, of 17 permature infants with IFI, and of 27 ones with non IFI, in whom bacterial culture was positive in 12 cases and culture was negative in 15 cases. The concentration of (1, 3)-β-D-glucan in IFI group[5~3 117 pg/ml, median (Q75-25) 190.60 (501.44) pg/ml] was higher than that in non IFI group[5.0~434.3 pg/ml, median (Q75-25) 5.86 (5.62) pg/ml], the difference was significant (Z=-3.77, P<0.01).15 pg/ml was the best cutoff value, and the area under curve was 0.839, 95%CI (0.697, 0.980). Conclusion G test is useful in the diagnosis of IFI in premature infants with high sensitivity and specificity. G test can be used for the screening of high-risk patients with high risk of fungal infection ratio. Key words: (1, 3)-β-D-glucan; Invasive fungal infection; Premature infant