Annals of Laboratory Medicine

Korean Society for Laboratory Medicine (대한진단검사의학회)
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Clinical Sensitivity of the (1-3)-β-ᴅ-glucan Test for Predicting Candidemia

  • Yun Woo Lee (Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine) ;
  • So Yun Lim (Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Sol Jin (Department of Infectious Diseases, Kosin University Gospel Hospital) ;
  • Hye Jin Park (Department of Infectious Diseases, Bumin Hospital) ;
  • Heungsup Sung (Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Mi-Na Kim (Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Seongman Bae (Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Jiwon Jung (Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Min Jae Kim (Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Sung-Han Kim (Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Sang-Oh Lee (Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Sang-Ho Choi (Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Yang Soo Kim (Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Yong Pil Chong (Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine)
  • Received : 2022.06.16
  • Accepted : 2022.12.28
  • Published : 2023.07.01
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Abstract

The sensitivity of the (1-3)-β-ᴅ-glucan (BDG) diagnostic test for candidemia varies in different clinical settings, and its usefulness in early diagnosis of candidemia is suboptimal. We evaluated the sensitivity of the test for early candidemia prediction. All adult patients with culture-proven candidemia who underwent a serum Goldstream Fungus (1-3)-β-ᴅ-Glucan Test within seven days prior to candidemia onset at a tertiary referral hospital between January 2017 and May 2021 were included. Any-positive BDG results within seven days prior to candidemia onset were obtained in 38 out of 93 (40.9%) patients. The positive rate increased when the test was performed near the day of candidemia onset (P =0.04) but reached only 52% on the day of candidemia onset. We observed no significant differences between BDG-positive and -negative groups in terms of underlying disease, risk factors for candidemia, clinical presentation, origin of candidemia, and 30-day mortality. Candida albicans was significantly associated with positive BDG results than with all-negative BDG results (P =0.04). The Goldstream BDG test is unreliable for candidemia prediction because of its low sensitivity. Negative BDG results in patients with a high risk of invasive candidiasis should be interpreted with caution.

Keywords

Acknowledgement

This research was supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Korea (grant number HI22C2010).

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