Abstract:
INTRODUCTION:Invasive fungal disease (IFD) remains a significant cause of morbidity and mortality in critically ill patients. METHODS:Examination of 1,3-β-D-glucan (BDG) for IFD and as outcome parameter in immunocompromised critically ill patients with septic shock. RESULTS:Thirty-two (69 %) out of 46 included patients had BDG beyond the cutoff of >80 pg/ml (mean 320 pg/ml). Twelve (37 %) had findings of Aspergillus spp. in BAL (mean BDG 413 pg/ml). EORTC/MSG guidelines classified these as probable invasive aspergillosis (IA)/IFD. Five (16 %) had candidaemia (mean BDG level 361 pg/ml). Sensitivity of 78 % (95 % CI 58-88 %) and specificity of 68 % (95 % CI 52-77 %) for IFD were found on the BDG Fungitell assay. In detail, a sensitivity of 73 % (95 % 58-84 %) and specificity of 83 % (95 % CI 68-93 %) for IA and a sensitivity of 77 % (CI 95 % 62-87 %) and specificity 53 % (95 % CI 37-73 %) for candidaemia were found. APACHE II, SOFA score and mortality rate were in the elevated BDG group significantly altered (26 vs. 21, p < 0.003; 15 vs. 13, p < 0.006; 72 vs. 50 %, p < 0.004). CONCLUSION:1,3-β-D-glucan assay is helpful for early detection of IFD; moreover, elevated BDG levels can be used as a predictor for outcome in immunocompromised critically ill patients as presented in our study.
journal_name
Mycopathologiajournal_title
Mycopathologiaauthors
Lahmer T,Held J,Rasch S,Schnappauf C,Beitz A,Schmid RM,Huber Wdoi
10.1007/s11046-016-0061-0subject
Has Abstractpub_date
2016-12-01 00:00:00pages
815-821issue
11-12eissn
0301-486Xissn
1573-0832pii
10.1007/s11046-016-0061-0journal_volume
181pub_type
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