EVALUATION OF (1,3)-B-D-GLUCAN ASSAY IN RESPIRATORY SAMPLES FOR DIAGNOSIS OF ASPERGILLOSIS
Keywords:
Aspergillus, respiratory tract, aspergillosis, 1,3-ß-D-glucan panfungal markerAbstract
Introduction: Aspergillosis is significant problem in immunocompromised and critically ill patients. Early diagnosis is still challenging, and therefore there is a need for rapid and more sensitive diagnostic methods.
Aim: the aim was to evaluate the performance, sensitivity and specificity of the panfungal (1,3)-b-D-glucan marker in respiratory samples, compared to conventional method, for early diagnosis of aspergillosis.
Material and methods: Samples of 125 patients divided into 4 groups, classified according to clinical diagnosis and EORTC/MSG criteria, were analysed at the Institute of Microbiology and Parasitology, with conventional methods and (1,3)-b-D-glucan marker in respiratory samples, during a period of two years.
Results: A total of 71 isolates of Aspergillus were confirmed in this study. Four isolates originated from bloodcultures. Culture of respiratory samples revealed Aspergillus in the group of chronic aspergillosis (63.33%), followed by groups of cystic fibrosis (56.67%), primary immune deficiency (51.43%), and the group with prolonged ICU stay (43.33%). Sensitivity and specificity of respiratory samples’ culture were: 64.29% and 100%, 59.09% and 100%, 54.55% and 12.5%, 100% and 54.17%, in all four groups, respectively. Sensitivity and specificity of panfungal (1,3)-b-D-glucan marker in respiratory samples, were: 71.43% and 85.71%, 72.73% and 62.5%, 68.18% and 0%, 50% and 50%, in all 4 groups, respectively.
Conclusion: Results of this study demonstrate that a positive (1,3)-b-D-glucan marker in respiratory samples highlights the value of this test as a diagnostic adjunct in diagnosis of aspergillosis, along with results from conventional mycological analyses, so timely antifungal treatment with a favorable clinical outcome, is achieved.
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