Mycopathologia

, Volume 182, Issue 3–4, pp 331–338 | Cite as

Diagnostic Values and Limitations of (1,3)-β-d-Glucans and Galactomannan Assays for Invasive Fungal Infection in Patients Admitted to Pediatric Intensive Care Unit

  • Fang Zheng
  • Hui Zha
  • Dandan Yang
  • Jun Deng
  • Zhiquan Zhang
Article

Abstract

The relationship among (1,3)-β-d-glucans (BG), galactomannan (GM), and the risk of developing invasive fungal infections (IFI) has been observed in adult ICU and in children with hematological malignancies. Only scant data evaluated the value of BG/GM assays for diagnosis of IFI in patients with nonhematological diseases in pediatric intensive care unit (PICU). In this study, we assessed the diagnostic value of these markers for IFI in PICU. The records of 230 patients were retrospectively evaluated. Out of 117 patients (7 proven, 23 probable, and 87 cases without evidence of IFI) performed GM and BG assays. The results showed many factors were associated with false-positive test results. Patients who aged over 3 years had higher levels of GM and BG than younger infants. The levels of BG were higher in subjects with dairy, human blood products, antibiotics, and corticosteroids therapy than in cases without these treatments. Unlike BG assay, GM assay was less susceptible to above-mentioned factors expect blood products. The levels of BG and GM in IFI cases were dramatically higher than in controls. The diagnostic performance of these assays showed that GM assay had better results when compared with BG assay. On the whole, negative predictive value in both GM and BG assays was dramatically higher than other diagnostic parameters. In conclusion, BG assay was highly susceptible to many factors, and GM assay could be useful for diagnosis of IFI for its high sensitivity, but the over benefit of this assay limited in its inadequate specificity. The comparative advantage of BG and BG assays lied in excluding IFI in non-hematological PICU patients.

Keywords

Fungal infection Galactomannan Glucan Pediatrics 

Notes

Acknowledgments

The financial support of this work is received from the National Nature Sciences Foundation of China (No. 81301954).

Compliance with Ethical Standards

Conflict of interest

No conflict of interest exits in the submission of this manuscript.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Copyright information

© Springer Science+Business Media Dordrecht 2016

Authors and Affiliations

  • Fang Zheng
    • 1
  • Hui Zha
    • 1
  • Dandan Yang
    • 1
  • Jun Deng
    • 2
  • Zhiquan Zhang
    • 1
  1. 1.Department of Pediatric, Union Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
  2. 2.Department of Hematology, Union Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina

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