Skip to main content
Journal cover image

Multicenter clinical evaluation of the (1-->3) beta-D-glucan assay as an aid to diagnosis of fungal infections in humans.

Publication ,  Journal Article
Ostrosky-Zeichner, L; Alexander, BD; Kett, DH; Vazquez, J; Pappas, PG; Saeki, F; Ketchum, PA; Wingard, J; Schiff, R; Tamura, H; Finkelman, MA; Rex, JH
Published in: Clin Infect Dis
September 1, 2005

BACKGROUND: Measurement of (1-->3)-beta-D-Glucan (BG) has emerged as an adjunct diagnostic strategy for invasive fungal infections (IFI). METHODS: Subjects at 6 clinical sites in the United States were enrolled as either fungal infection-negative subjects (n = 170) or subjects with proven or probable IFI according to European Organization for the Research and Treatment of Cancer/Mycoses Study Group criteria (n = 163). A central laboratory and 4 sites performed assays. A single sample was obtained per patient and was evaluated using an assay to detect serum BG derived from fungal cell walls (range, 0 to > 7000 pg/mL). RESULTS: At a cutoff of 60 pg/mL, the sensitivity and specificity of the assay were 69.9% and 87.1%, respectively, with a positive predictive value (PPV) of 83.8% and a negative predictive value (NPV) of 75.1%. At a cutoff value of 80 pg/mL, the sensitivity and specificity were 64.4% and 92.4%, respectively, with a PPV of 89% and an NPV of 73%. Of the 107 patients with proven candidiasis, 81.3% had positive results at a cutoff value of 60 pg/mL, and 77.6% had positive results at a cutoff value of 80 pg/mL. Of the 10 patients with aspergillosis, 80% had positive results at cutoff values of 60 and 80 pg/mL. The 3 subjects diagnosed with Fusarium species had positive results at a cutoff value of 60 pg/mL. Patients infected with Mucor or Rhizopus species (both of which lack BG) had negative results at both cutoff values, and of the 12 patients with Cryptococcus infection, 3 had positive results at a cutoff value of 60 pg/mL, and 2 had positive results at a cutoff value of 80 pg/mL. Of the subjects with proven positive results who were receiving antifungal therapy (n = 118), 72.9% had results positive for BG at a cutoff value of 60 pg/mL, and 69.5% had results positive for BG at a cutoff value of 80 pg/mL. The interlaboratory sample test r2 was 0.93. CONCLUSION: Reproducible assay results with high specificity and high PPV in a multicenter setting demonstrate that use of an assay to detect serum BG derived from fungal cell walls is a useful diagnostic adjunct for IFI.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Clin Infect Dis

DOI

EISSN

1537-6591

Publication Date

September 1, 2005

Volume

41

Issue

5

Start / End Page

654 / 659

Location

United States

Related Subject Headings

  • beta-Glucans
  • Sensitivity and Specificity
  • Reproducibility of Results
  • Proteoglycans
  • Mycoses
  • Middle Aged
  • Microbiology
  • Male
  • Humans
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Ostrosky-Zeichner, L., Alexander, B. D., Kett, D. H., Vazquez, J., Pappas, P. G., Saeki, F., … Rex, J. H. (2005). Multicenter clinical evaluation of the (1-->3) beta-D-glucan assay as an aid to diagnosis of fungal infections in humans. Clin Infect Dis, 41(5), 654–659. https://doi.org/10.1086/432470
Ostrosky-Zeichner, Luis, Barbara D. Alexander, Daniel H. Kett, Jose Vazquez, Peter G. Pappas, Fumihiro Saeki, Paul A. Ketchum, et al. “Multicenter clinical evaluation of the (1-->3) beta-D-glucan assay as an aid to diagnosis of fungal infections in humans.Clin Infect Dis 41, no. 5 (September 1, 2005): 654–59. https://doi.org/10.1086/432470.
Ostrosky-Zeichner L, Alexander BD, Kett DH, Vazquez J, Pappas PG, Saeki F, et al. Multicenter clinical evaluation of the (1-->3) beta-D-glucan assay as an aid to diagnosis of fungal infections in humans. Clin Infect Dis. 2005 Sep 1;41(5):654–9.
Ostrosky-Zeichner, Luis, et al. “Multicenter clinical evaluation of the (1-->3) beta-D-glucan assay as an aid to diagnosis of fungal infections in humans.Clin Infect Dis, vol. 41, no. 5, Sept. 2005, pp. 654–59. Pubmed, doi:10.1086/432470.
Ostrosky-Zeichner L, Alexander BD, Kett DH, Vazquez J, Pappas PG, Saeki F, Ketchum PA, Wingard J, Schiff R, Tamura H, Finkelman MA, Rex JH. Multicenter clinical evaluation of the (1-->3) beta-D-glucan assay as an aid to diagnosis of fungal infections in humans. Clin Infect Dis. 2005 Sep 1;41(5):654–659.
Journal cover image

Published In

Clin Infect Dis

DOI

EISSN

1537-6591

Publication Date

September 1, 2005

Volume

41

Issue

5

Start / End Page

654 / 659

Location

United States

Related Subject Headings

  • beta-Glucans
  • Sensitivity and Specificity
  • Reproducibility of Results
  • Proteoglycans
  • Mycoses
  • Middle Aged
  • Microbiology
  • Male
  • Humans
  • Female