Reactivity of (1→3)-β-
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            -Glucan Assay with Commonly Used Intravenous Antimicrobials

Marty, Francisco M.; Lowry, Colleen M.; Lempitski, Steven J.; Kubiak, David W.; Finkelman, Malcolm; Baden, Lindsey R.

doi:10.1128/aac.00658-06

Cited by 143 publications

(72 citation statements)

References 16 publications

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“…In our study, only 5 (31.2%) of the 16 patients who had a false-positive GM assay due to cross-reaction with ␤-lactams were BG positive, a finding which indicates a lesser degree of cross-reaction of the BG test with these antibiotics. In line with these findings, BG was not detected in vitro at concentrations up to the theoretical maximal plasma concentration for 45 different intravenous antibiotics, including piperacillin-tazobactam (13).…”

Section: Discussionsupporting

confidence: 71%

Contribution of the (1→3)-β- d -Glucan Assay for Diagnosis of Invasive Fungal Infections

et al. 2008

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Diagnosis of invasive fungal infection (IFI) remains, and in all who had P. jiroveci pneumonias (100%), and the false-positive rate varied depending on the controls used. It allowed a higher rate of detection among IPA patients compared to the galactomannan enzyme-linked immunosorbent assay (ELISA) (48 versus 39 patients, respectively) and among candidemia patients compared to the mannan ELISA (20 versus 11 patients, respectively). This assay therefore appears to be useful in the diagnosis of IFI, particularly for serum analysis of pneumocystosis pneumonia patients, but further studies are needed to evaluate false-positive rates and its future role in IFI diagnosis.

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Section: Discussionsupporting

confidence: 71%

Contribution of the (1→3)-β- d -Glucan Assay for Diagnosis of Invasive Fungal Infections

et al. 2008

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“…Therefore, it is possible that the spectrum of fungal species implicated in this outbreak had an effect on the sensitivity of the assay. False-positive serum BDG results have been reported with a variety of factors, including bacteremia (17), intravenous ␤-lactam antibiotic therapy (18,19), hemodialysis membranes (20,21), gauze packing (22), and intravenous immunoglobulin administration (23). It is possible that these factors may not cause false-positive results with CSF samples due to the blood-brain barrier, leading to increased specificity with CSF samples.…”

Section: Discussionmentioning

confidence: 99%

(1,3)-β- d -Glucan in Cerebrospinal Fluid for Diagnosis of Fungal Meningitis Associated with Contaminated Methylprednisolone Injections

Malani

Singal

Wheat³

et al. 2015

J Clin Microbiol

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Prompt diagnosis and treatment of fungal meningitis are critical, but culture is insensitive. (1,3)-␤-D-Glucan (BDG) testing is FDA approved for serological diagnosis of invasive fungal disease; however, BDG testing is not approved for cerebrospinal fluid (CSF), and the appropriate cutoff value is unknown. We aimed to validate the diagnostic accuracy of CSF BDG measurements for fungal meningitis among patients exposed to contaminated methylprednisolone acetate (MPA). A retrospective observational study was conducted at St. Joseph Mercy Hospital and Vanderbilt University from November 2013 to February 2014. Patients were included if they had received a contaminated MPA injection. Cases were classified as probable or proven meningitis according to Centers for Disease Control and Prevention guidelines. CSF BDG testing was performed according to the package insert instructions for serum samples, and results were validated using Clinical and Laboratory Standards Institute procedures (MiraVista Diagnostics). Of 233 patients, 45 had meningitis (28 proven cases), 53 had spinal/paraspinal infections (19 proven cases), and 135 did not develop disease. Using the manufacturer's cutoff value (>80 pg/ml), the sensitivity and specificity were 96% and 95%, respectively, for proven meningitis and 84% and 95% for probable or proven meningitis. Receiver operating characteristic analysis identified the optimal cutoff value for proven meningitis to be 66 pg/ml (sensitivity, 100%; specificity, 94%) and that for probable or proven meningitis to be 66 pg/ml (sensitivity, 91%; specificity, 92%). Our results suggest that CSF BDG measurements are highly sensitive and specific for the diagnosis of fungal meningitis associated with contaminated MPA injections. Further study on the utility of CSF BDG testing for other types of fungal meningitis is needed. P rompt diagnosis and administration of appropriate therapy are critical to improving clinical outcomes for patients with invasive fungal disease (IFD) (1, 2); however, the diagnosis of IFD can be difficult (3). Definitive diagnoses are most often based on direct observation and/or isolation of a fungal organism from a sterile site (4). Fungal cultures have been shown to be insensitive (5), however, and the collection of adequate samples for culture may require invasive procedures (6). Sensitive and rapid serological assays have been approved for the diagnosis of IFD, but many have not been validated using nonserological samples (4).In May 2004, the serum Fungitell assay (Associates of Cape Cod Inc., East Falmouth, MA) was approved by the Food and Drug Administration (FDA) for use in the United States. A recent meta-analysis comparing serum (1,3)-␤-D-glucan (BDG) levels among patients with proven or probable IFD versus those without IFD revealed a pooled sensitivity of 76.8% (95% confidence interval [CI], 67.1% to 84.3%) and specificity of 85.3% (95% CI, 79.6% to 89.7%) (7). However, this assay has not been validated or FDA approved for testing of cerebrospinal fluid (CSF), and the appropri...

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“…False positive results may be seen for BDG because it is ubiquitous in the environment. Furthermore, some conditions such as exposure to certain gauzes [25], taking several antibiotics at high concentrations [26], using certain hemodialysis cellulose membranes [27], and receipt of albumin or immunoglobulin products, plasma proteins or coagulation factors [28] may contribute to a greater yield of false positive. False positives by BDG may also be obtained by a variety of other reasons including "bacteremia, hemolysis; intravenous administration of treatment with certain medications; exposure to cotton bandages; heat stroke; and unknown causes" [29,30].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic potential of nested PCR, galactomannan EIA, and Beta-D-glucan for invasive aspergillosis in pediatric patients

Badiee

Alborzi

Karimi

et al. 2012

J Infect Dev Ctries

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Introduction: Limited specific data and investigations are available for invasive aspergillosis (IA) in pediatric patients. We evaluated the diagnostic potential of three noninvasive tests including the Platelia Aspergillus EIA kit for using galactomannan antigen, (1,3)-β-D-glucan Detection Reagent Kit, and nested-PCR for Aspergillus DNA in sera. We evaluated the diagnostic potential of three noninvasive tests including EIA for galactomannan antigen (Platelia Aspergillus), nested PCR assay for Aspergillus DNA and test for (1→3)-β-D-glucan (Glucatell assay Kit). Methodology: All pediatric patients treated at the hematology/oncology unit who were at increased risk of developing invasive aspergillosis were enrolled. Clinical samples were examined for Aspergillus infections by mycological methods. Serial blood samples were collected twice weekly and evaluated by noninvasive tests. Results: We analyzed 230 consecutive blood samples from 62 pediatric patients. The incidence rate of invasive aspergillosis in the patients was found to be 27.4%, and the etiologic agents were Aspergillus flavus, Aspergillus fumigatus, and Aspergillus spp. The sensitivity, specificity, positive and negative predictive values, and likelihood ratios for positive and negative results of galactomannan in patients with proven and probable IA were 90%, 92%, 81.8%, 96%, 11.25, and 0.1; for beta-D-glucan they were 50%, 46%, 26%, 70.6%, 0.9, 0.9; and for nested-PCR they were 80%, 96.2%, 88.9%, 92.6%, 21, and 0.2, respectively. Conclusions: The conventional methods are not able to detect IA, due to the lack of valid and proper sampling. Galactomannan and nested-PCR tests in serum, with enough accuracy and reliability, can serve as noninvasive methods for the detection of IA in pediatric patients. However, the beta-D-glucan test cannot serve as an efficient diagnostic tool in those with hematologic disorders.

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Reactivity of (1→3)-β- d -Glucan Assay with Commonly Used Intravenous Antimicrobials

Cited by 143 publications

References 16 publications

Contribution of the (1→3)-β- d -Glucan Assay for Diagnosis of Invasive Fungal Infections

Contribution of the (1→3)-β- d -Glucan Assay for Diagnosis of Invasive Fungal Infections

(1,3)-β- d -Glucan in Cerebrospinal Fluid for Diagnosis of Fungal Meningitis Associated with Contaminated Methylprednisolone Injections

Diagnostic potential of nested PCR, galactomannan EIA, and Beta-D-glucan for invasive aspergillosis in pediatric patients

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