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Performance evaluation of the (1,3)-β-D-glucan detection assay in non-intensive care unit adult patients

OBJECTIVES: To assess the performance of the (1,3)-β-D-glucan (BDG) detection assay in a large cohort of patients with suspected candidemia who were admitted to non-intensive care unit hospital wards. METHODS: This observational, retrospective cohort study was conducted in a 1,100-bed university hos...

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Autores principales: Murri, Rita, Camici, Marta, Posteraro, Brunella, Giovannenze, Francesca, Taccari, Francesco, Ventura, Giulio, Scoppettuolo, Giancarlo, Sanguinetti, Maurizio, Cauda, Roberto, Fantoni, Massimo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6304239/
https://www.ncbi.nlm.nih.gov/pubmed/30588044
http://dx.doi.org/10.2147/IDR.S181489
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author Murri, Rita
Camici, Marta
Posteraro, Brunella
Giovannenze, Francesca
Taccari, Francesco
Ventura, Giulio
Scoppettuolo, Giancarlo
Sanguinetti, Maurizio
Cauda, Roberto
Fantoni, Massimo
author_facet Murri, Rita
Camici, Marta
Posteraro, Brunella
Giovannenze, Francesca
Taccari, Francesco
Ventura, Giulio
Scoppettuolo, Giancarlo
Sanguinetti, Maurizio
Cauda, Roberto
Fantoni, Massimo
author_sort Murri, Rita
collection PubMed
description OBJECTIVES: To assess the performance of the (1,3)-β-D-glucan (BDG) detection assay in a large cohort of patients with suspected candidemia who were admitted to non-intensive care unit hospital wards. METHODS: This observational, retrospective cohort study was conducted in a 1,100-bed university hospital in Rome, where an infectious disease consultation team has been operational. Two groups of patients were included in the analysis: Group 1, patients with Candida bloodstream infection (BSI) who had at least one BDG test performed ±48 hours from the first positive blood culture (Candida BSI Group) and Group 2, patients with risk factors for candidemia who had at least one BDG test but had negative blood cultures (Control Group). Both Group 1 and Group 2 did not receive prior antifungal therapy. Different BDG cutoff values were considered: 80, 200, 300, 400, and ≥500 pg/mL. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the receiver operating characteristic curve were calculated. RESULTS: A total of 1,296 patients were studied. Of them, 100 patients (candidemic) were in Group 1 and the remaining 1,196 patients (controls) were in Group 2. There were no differences in demographic characteristics between patients of the two groups. According to the above cutoff values, sensitivity (%) and specificity (%) of the BDG assay ranged from 91 to 60.7 and 87.7 to 97.8, respectively, whereas the PPV (%) and NPV (%) ranged from 38.2 to 68.3 and 99.1 to 97.0, respectively. CONCLUSION: Serum BDG has a very high NPV in a population witĥ10% prevalence of candidemia. This NPV may support decisions to discontinue antifungal therapy in those patients who were empirically treated because of the suspect of candidemia.
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spelling pubmed-63042392018-12-26 Performance evaluation of the (1,3)-β-D-glucan detection assay in non-intensive care unit adult patients Murri, Rita Camici, Marta Posteraro, Brunella Giovannenze, Francesca Taccari, Francesco Ventura, Giulio Scoppettuolo, Giancarlo Sanguinetti, Maurizio Cauda, Roberto Fantoni, Massimo Infect Drug Resist Original Research OBJECTIVES: To assess the performance of the (1,3)-β-D-glucan (BDG) detection assay in a large cohort of patients with suspected candidemia who were admitted to non-intensive care unit hospital wards. METHODS: This observational, retrospective cohort study was conducted in a 1,100-bed university hospital in Rome, where an infectious disease consultation team has been operational. Two groups of patients were included in the analysis: Group 1, patients with Candida bloodstream infection (BSI) who had at least one BDG test performed ±48 hours from the first positive blood culture (Candida BSI Group) and Group 2, patients with risk factors for candidemia who had at least one BDG test but had negative blood cultures (Control Group). Both Group 1 and Group 2 did not receive prior antifungal therapy. Different BDG cutoff values were considered: 80, 200, 300, 400, and ≥500 pg/mL. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the receiver operating characteristic curve were calculated. RESULTS: A total of 1,296 patients were studied. Of them, 100 patients (candidemic) were in Group 1 and the remaining 1,196 patients (controls) were in Group 2. There were no differences in demographic characteristics between patients of the two groups. According to the above cutoff values, sensitivity (%) and specificity (%) of the BDG assay ranged from 91 to 60.7 and 87.7 to 97.8, respectively, whereas the PPV (%) and NPV (%) ranged from 38.2 to 68.3 and 99.1 to 97.0, respectively. CONCLUSION: Serum BDG has a very high NPV in a population witĥ10% prevalence of candidemia. This NPV may support decisions to discontinue antifungal therapy in those patients who were empirically treated because of the suspect of candidemia. Dove Medical Press 2018-12-20 /pmc/articles/PMC6304239/ /pubmed/30588044 http://dx.doi.org/10.2147/IDR.S181489 Text en © 2019 Murri et al. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Original Research
Murri, Rita
Camici, Marta
Posteraro, Brunella
Giovannenze, Francesca
Taccari, Francesco
Ventura, Giulio
Scoppettuolo, Giancarlo
Sanguinetti, Maurizio
Cauda, Roberto
Fantoni, Massimo
Performance evaluation of the (1,3)-β-D-glucan detection assay in non-intensive care unit adult patients
title Performance evaluation of the (1,3)-β-D-glucan detection assay in non-intensive care unit adult patients
title_full Performance evaluation of the (1,3)-β-D-glucan detection assay in non-intensive care unit adult patients
title_fullStr Performance evaluation of the (1,3)-β-D-glucan detection assay in non-intensive care unit adult patients
title_full_unstemmed Performance evaluation of the (1,3)-β-D-glucan detection assay in non-intensive care unit adult patients
title_short Performance evaluation of the (1,3)-β-D-glucan detection assay in non-intensive care unit adult patients
title_sort performance evaluation of the (1,3)-β-d-glucan detection assay in non-intensive care unit adult patients
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6304239/
https://www.ncbi.nlm.nih.gov/pubmed/30588044
http://dx.doi.org/10.2147/IDR.S181489
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