Diagnostic value of serum human Galactomannan aspergillus antigen and 1,3‐beta‐D‐glucan in immunocompromised patient suspected fungal infection

Autor: Hani Susianti, Ungky Agus Setyawan, Lydiana Parmadi, Novi Khila Firani, Teguh Rahayu Sartono
Rok vydání: 2021
Předmět:
Male
0301 basic medicine
beta-Glucans
Microbiological culture
Lymphocyte
Clinical Biochemistry
Serology
Mannans
chemistry.chemical_compound
0302 clinical medicine
Immunology and Allergy
Medicine
Research Articles
Hematology
biology
Middle Aged
Prognosis
immunocompromised
Medical Laboratory Technology
fungal Infection
Aspergillus
1
3-Beta-glucan synthase
medicine.anatomical_structure
030220 oncology & carcinogenesis
Female
Research Article
Adult
Microbiology (medical)
medicine.medical_specialty
Antigens
Fungal
Adolescent
Neutropenia
Immunocompromised Host
Young Adult
03 medical and health sciences
Galactomannan
Internal medicine
Humans
haematology parameters
Aged
business.industry
Monocyte
Biochemistry (medical)
Public Health
Environmental and Occupational Health
Galactose
medicine.disease
Cross-Sectional Studies
030104 developmental biology
Mycoses
chemistry
galactomannan
Immunology
biology.protein
1
3‐beta‐d‐glucan
business
Follow-Up Studies
Zdroj: Journal of Clinical Laboratory Analysis
ISSN: 1098-2825
0887-8013
DOI: 10.1002/jcla.23806
Popis: Background The prevalence of fungal infection (FI) in developing countries is high, but the diagnosis of FI is still challenging to determine, so it is needed evaluation of biomarkers other than microbiological culture, because the culture has low sensitivity, high cost, not available in every laboratory and needs a long time. The detection of human galactomannan Aspergillus antigen (GAL) and 1,3‐beta‐D‐glucan (BDG) on the fungal cell wall could be the promising biomarkers for fungal infection. Neutropenia, lymphopenia and CD4T cells in the immunocompromised patients are essential factors, but these cell associations with BDG and GAL levels have not been evaluated yet. The study aimed to evaluate GAL and BDG for detecting fungal infection and their association with total leucocyte count, neutrophil, monocyte, lymphocyte and CD4T cells. Method A cross‐sectional study was conducted among 86 patient with suspected FI. Fungal infection established using EORTC/MSG criteria. Serology test performed using ELISA. Leucocyte cells were measured using a haematology autoanalyser, and CD4T cells were analysed using BD FACSPresto. Statistical analysis obtained using Spearman's correlation coefficient, ROC curve analysis and 2 × 2 contingency table. Results Serum Galactomannan and BDG had a significant correlation with CD4T cells and total lymphocyte count (p 0.3 had sensitivity 54.6%, specificity 87.5% and AUC 0.71; meanwhile, the BDG cut‐off >115.78 pg/ mL had sensitivity 71.2%, specificity 52.4% and AUC 0.63 for detecting fungal infection. Conclusions The immunocompromised patients can undergo GAL for determining the diagnose of FI. The lower the CD4T cells and total lymphocyte count, the higher the GAL and BDG serum levels.
The prevalence of fungal infection (FI) in developing countries is high, but the diagnosis of FI is still challenging to determine, so it is needed evaluation of biomarkers other than microbiological culture, because the culture has low sensitivity, high cost, not available in every laboratory and needs a long time. The detection of Human Galactomannan Aspergillus Antigen (GAL) and 1,3‐Beta‐D‐Glucan (BDG) on the fungal cell wall could be the promising biomarkers for fungal infection. Neutropenia, lymphopenia and CD4T‐cells in the immunocompromised patients are essential factors, but these cells association with BDG and GAL levels have not evaluated yet. The study aimed to evaluate GAL and BDG for detecting fungal infection and their association with total leucocyte count, neutrophil, monocyte, lymphocyte and CD4T‐cells. As the results of this study, GAL and BDG had a significant correlation with CD4T‐cells and total lymphocyte count (p 0.3 had sensitivity 54.6%, specificity 87.5% and AUC 0.71, meanwhile the BDG cut off >115.78 pg/ mL had sensitivity 71.2%, specificity 52.4% and AUC 0.63 for detecting fungal infection. So that for conclusions, immunocompromised patients can undergo GAL for determining the diagnose of FI. The lower the CD4T‐cells and total lymphocyte count, the higher the GAL and BDG serum concentration. ​
Databáze: OpenAIRE
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