Early serum (1→3)‐β‐D‐glucan levels in patients with burn injury

Serum (1→3)‐β‐D‐glucan (BG) is increasingly used as diagnostic marker for invasive fungal infections. Exposure to gauze may lead to false‐positive BG assays. The role of BG is unclear in thermally injured patients who frequently require extensive gauze coverage; therefore, we prospectively evaluated BG levels in burn‐injured patients. Serum BG levels were measured in 18 burn patients immediately before application of the first dressing and 12 h after. Patients were stratified by extent of total body surface area (TBSA) requiring gauze coverage: <20%, 20–39%, 40–60% and >60%. BG levels were obtained from patients with non‐burn trauma as controls. BG results were positive (>80 pg ml−1) in 9/18 (50%) patients at baseline and in 8/18 (44%) 12 h after application of the first dressing. BG levels were positive in 1/5 (20%) of patients with <20% TBSA requiring gauze and in 10/13 (77%) with ≥20% (P < 0.05). None of the control patients had positive BG at any time point and none of the patients had candidemia at baseline. Mean serum BG levels decreased (19.44 pg ml−1) after gauze placement. False‐positive serum BG elevations are common in this patient population. Positivity correlates with extent of TBSA injured, but is not impacted by the gauze itself.