ASSESSMENT OF β-D-(1→3)-GLUCAN ASSAY FOR DIAGNOSIS OF INVASIVE FUNGAL INFEC- TIONS

Aim: Invasive fungal infections (IFIs) are associated with high mortality and morbidity. However, the diagnosis of IFIs in an immunocompromised host is difficult and often missed or delayed. Our aim was to investigate the feasibility of the (1→3)-β-DGlucan assay as a diagnostic complement for IFIs. Methods: We reviewed the records of all inpatients in various units at Erciyes University’s Medical Faculty Hospital (Kayseri, Turkey) who had at least one (1→3)-β-D-Glucan assay result from August 2009 to April 2011. According to the criteria of the European Organization for the Research and Treatment of Cancer/Mycoses Study Group, IFI was classified into three clinical categories: proven, probable, and possible. Serum (1→3)-β-D-Glucan was estimated using the Fungitell assay according to the manufacturer’s instructions (Associates of Cape Cod, East Falmouth, Ma, USA). Optical density index ≥ 80 pg/ml was considered positive. Results: Of the 83 patients who underwent (1→3)-β-D-Glucan assay, five patients were classified as having proven IFI, 18 patients had probable IFI and 20 patients had possible IFI. The overall (proven+probable+possible) sensitivity, specificity, positive predictive value and negative predictive value of the BG assay were 81% (95% confidence interval, 67-92%), 88% (95% confidence interval, 73-96%), 88% (95% confidence interval, 73-96%), and 81% (95% confidence interval, 67-92%), respectively. Conclusions: In this study, we evaluated the utility of the (1→3)-β-D-Glucan assay as a diagnostic complement for IFIs. Our results suggest that (1→3)-β-D-Glucan is a beneficial marker for the diagnosis of IFIs.