Diagnostic value of β-D-glucan alone or combined with Candida score, colonization index and C-reactive protein for candidemia

  • Sumeyye Kazancioglu Department of Infectious Diseases and Clinical Microbiology, Ankara City Hospital, Ankara, Turkey
  • Aliye Bastug Department of Infectious Diseases and Clinical Microbiology, Health Science University Turkey, Ankara City Hospital, Ankara, Turkey
  • Bircan Kayaaslan Department of Infectious Diseases and Clinical Microbiology, Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey
  • Nevzat Mehmet Mutlu Department of Anesthesiology, Ankara City Hospital, Ankara, Turkey
  • Esin Calci Department of Clinical Biochemistry, Uşak Public Health laboratory, Uşak, Turkey
  • Turan Turhan Department of Clinical Biochemistry, Ankara City Hospital, Ankara, Turkey
  • Ipek Mumcuoglu Department of Clinical Microbiology, Ankara City Hospital, Ankara, Turkey
  • Esragul Akinci Department of Infectious Diseases and Clinical Microbiology, Health Science University Turkey, Ankara City Hospital, Ankara, Turkey
  • Hurrem Bodur Department of Infectious Diseases and Clinical Microbiology, Health Science University Turkey, Ankara City Hospital, Ankara, Turkey
Keywords: Candidemia, (1,3)-β-D-glucan, C-reactive protein, ICU

Abstract

Introduction: Candidemia causes high mortality and is occuring at increasing rate in intensive care units (ICUs). (1,3)- β-D-glucan (BDG) testing is recommended in neutropenic patients. However the usefulness of BDG in ICUs is unclear.

Methodology: This study was conducted to compare the diagnostic value of Candida score (CS), colonization index (CI), serum BDG detection, and routine laboratory parameters in ICU patients. Characteristics and laboratory data of 83 patients (15 patients with candidemia and 68 patients without candidemia) were evaluated.

Results: Median serum BDG was significantly higher in the candidemia group (129 pg/mL vs. 36 pg/mL, p < 0.001). BDG assay with standard cut-off value ≥ of 80 pg/mL had 93.33% sensitivity and 64.18% specificity (Areas under the ROC curve (AUC): 0.788). This study concluded that the optimal cut-off value for BDG assay was 112 pg/mL with sensitivity of 86.67% and specificity of 82.09% (AUC: 0.844). C-reactive protein (CRP) with optimal cut-off value ≥ 85 mg/L and BDG ≥ 80 pg/mL had the highest AUC (0.862, 95% CI: 0.768 - 0.928) with sensitivity 93.33% and specificity 79.1%.

Conclusions: Predicting candidemia is essential in critically ill patients who are at high risk and have high mortality rates. The results of this study suggest that BDG testing is useful for predicting candidemia in ICU. However, BDG combined with CRP may be a stronger predictor for candidemia.

Published
2022-02-28
How to Cite
1.
Kazancioglu S, Bastug A, Kayaaslan B, Mutlu NM, Calci E, Turhan T, Mumcuoglu I, Akinci E, Bodur H (2022) Diagnostic value of β-D-glucan alone or combined with Candida score, colonization index and C-reactive protein for candidemia. J Infect Dev Ctries 16:362-368. doi: 10.3855/jidc.15711
Section
Original Articles