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首页> 外文期刊>Journal of Clinical Microbiology >Prospective Survey of (1→3)-β-d-Glucan and Its Relationship to Invasive Candidiasis in the Surgical Intensive Care Unit Setting
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Prospective Survey of (1→3)-β-d-Glucan and Its Relationship to Invasive Candidiasis in the Surgical Intensive Care Unit Setting

机译：外科重症监护病房设置（1→3）-β-d-葡聚糖及其与侵袭性念珠菌病的关系

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Non-culture-based diagnostic strategies are needed for diagnosing invasive candidiasis (IC). We evaluated serial serum (1→3)-β-d-glucan (BG) levels in patients in the surgical trauma intensive care unit (SICU) patients with clinical evidence of IC. Serum samples from patients admitted to the SICU for a minimum of 3 days were collected twice weekly and analyzed for BG by using a Fungitell kit with a positive cutoff of ≥80 pg/ml. Diagnosis of IC was done using a set of predefined and validated clinical practice-based criteria. A total of 57 patients consented to participate and were enrolled. The median ICU stay was 16 days (range, 3 to 51). A total of 14 of 57 (25%) false positives were observed in the first sample (ICU day 3) and, overall, 73% of the day 3 samples had higher BG levels than subsequent samples. On the date of clinical diagnosis of IC, the sensitivity of a positive BG for identifying invasive candidiasis was 87%, with a 73% specificity. In patients with evidence of IC, the median BG value was significantly higher than those without evidence of IC (171 versus 48 pg/ml, P = 0.02), respectively. In the three patients with proven IC, BG was detected 4 to 8 days prior to diagnosis. BG serum detection may be a useful tool to aid in the early diagnosis of IC in SICU patients, particularly after day 3 and in patients with at least two positive samples drawn several days apart. Elevated BG levels within the first 3 days need to be further characterized.
机译：诊断侵入性念珠菌病（IC）需要基于非文化的诊断策略。我们评估了具有IC临床证据的外科创伤重症监护病房（SICU）患者的血清（1→3）-β-d-葡聚糖（BG）水平。每周两次收集入SICU至少3天的患者的血清样本，并使用Fungitell试剂盒对BG进行分析，其阳性截断值≥80 pg / ml。使用一组预定义和经过验证的基于临床实践的标准对IC进行诊断。共有57位患者同意参与并入组。 ICU的中位停留时间为16天（范围为3到51）。在第一个样本中（ICU第3天）观察到总共14个（57％）假阳性（25％），总的来说，第3天样本中有73％的BG水平高于后续样本。在IC的临床诊断日期，阳性BG识别浸润性念珠菌病的敏感性为87％，特异性为73％。有IC证据的患者中，BG的中值明显高于无IC证据的患者（分别为171 pg和48 pg / ml， P = 0.02）。在三例经证实具有IC的患者中，诊断前4至8天检测到BG。 BG血清检测可能是有助于SICU患者IC早期诊断的有用工具，尤其是在第3天之后以及至少有几天间隔抽取两个阳性样品的患者。前3天内BG水平升高需要进一步表征。

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