(1,3)‐β‐D‐glucan is able to predict therapeutic failure of patients with candidemia and not only mortality.

Autor: Esteves, Patrícia, Lopes Lima, Soraia, Salles de Azevedo Melo, Analy, Maria Beirão, Elisa, Nucci, Marcio, Colombo, Arnaldo L.
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Zdroj: Mycoses; Mar2021, Vol. 64 Issue 3, p264-271, 8p
Abstrakt: Background: Candidemia is a major cause of bloodstream infection in tertiary hospitals worldwide and fungal biomarkers may provide early diagnosis. Objectives: To evaluate the performance of (1‐3)‐β‐D‐glucan (BDG) in the diagnosis of candidemia and its ability to predict therapeutic failure. Patients and Methods: This was a prospective, multi‐centre study conducted in 3 Brazilian hospitals. Clinical outcome was evaluated along 2 weeks of treatment, and therapeutic failure was defined as the occurrence of persistent candidemia, Candida deep‐seated infection or death. Baseline BDG detection was performed with the Fungitell® assay (Associates of Cape Cod, Falmouth—USA). Results: We enrolled a total of 71 patients with candidemia and a control group with 110 healthy volunteers. The sensitivity and specificity of BDG for diagnosing candidemia were as follows: 71.8% (95% confidence interval [95% CI] 59.7% ‐ 81.5%) and 98.2% (95% CI 92.9% ‐ 99.7%), respectively. The only predictor of therapeutic failure was a higher BDG value at diagnosis of candidemia; a value > 226 pg/mL predicted failure with sensitivity and specificity of 75% and 78%, respectively. Conclusions: A high baseline serum BDG value was associated with therapeutic failure. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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