Serum Beta-D-Glucan in the Diagnosis of Invasive Fungal Disease in Neonates, Children and Adolescents: A Critical Analysis of Current Data

Ferreras-Antolín, Laura; Borman, Andrew M.; Diederichs, Antonia; Warris, Adilia; Lehrnbecher, Thomas

doi:10.3390/jof8121262

Cited by 10 publications

(6 citation statements)

References 44 publications

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“… 17 However, specificity of BDG was shown to be lower (50%–70%) in non-hematologic cancer patients (e.g., solid-organ transplant recipients) or in children/neonates. 82 , 83 …”

Section: Discussionmentioning

confidence: 99%

Performance of the beta-glucan test for the diagnosis of invasive fusariosis and scedosporiosis: a meta-analysis

et al. 2023

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The (1→3)-β-D-glucan (BDG) is a component of the fungal cell wall that can be detected in serum and used as an adjunctive tool for the diagnosis of invasive mold infections (IMI) in patients with hematologic cancer or other immunosuppressive conditions. However, its use is limited by modest sensitivity/specificity, inability to differentiate between fungal pathogens and lack of detection of mucormycosis. Data about BDG performance for other relevant IMI, such as invasive fusariosis (IF) and invasive scedosporiosis/lomentosporiosis (IS) are scarce. The objective of this study was to assess the sensitivity of BDG for the diagnosis of IF and IS through systematic literature review and meta-analysis. Immunosuppressed patients diagnosed with proven or probable IF and IS, with interpretable BDG data were eligible. A total of 73 IF and 27 IS cases were included. The sensitivity of BDG for IF and IS diagnosis was 76.7% and 81.5%, respectively. In comparison, the sensitivity of serum galactomannan for IF was 27%. Importantly, BDG positivity preceded the diagnosis by conventional methods (culture or histopathology) in 73% and 94% of IF and IS cases, respectively. Specificity was not assessed because of lacking data. In conclusion, BDG testing may be useful in patients with suspected IF or IS. Combining BDG and galactomannan testing may also help differentiating between the different types of IMI.

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“… 17 However, specificity of BDG was shown to be lower (50%–70%) in non-hematologic cancer patients (e.g., solid-organ transplant recipients) or in children/neonates. 82 , 83 …”

Section: Discussionmentioning

confidence: 99%

Performance of the beta-glucan test for the diagnosis of invasive fusariosis and scedosporiosis: a meta-analysis

et al. 2023

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“…Авторы обнаружили, что исходные значения 1,3βDглюкана в этих условиях были примерно на треть выше у детей, чем у взрослых [35]. Вследствие ограниченности дан ных нет рекомендаций по использованию теста на 1,3βDглюкан для диагностики инвазивного кан дидоза у детей [36]. Возможность использования теста на 1,3βDглюкан для оценки эффективности про тивогрибковой терапии у детей также нуждается в дальнейшем изучении.…”

Section: таблица 2 микологические признаки вероятного плесневого инва...unclassified

Benefits of early antifungal therapy in hematology patients

Andreev,

Bronin,

Epifanova

et al. 2024

Onkogematologiâ

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Invasive fungal infections (IFIs) are a serious threat to patients with hematological diseases. These infections are characterized by high mortality and lead to significant financial costs for treatment. The most common pathogens of IFIs are Aspergillus spp. and Candida spp., but in recent years, cases of infections caused by rare pathogens have become more frequent. Diagnosis of IFIs and choice of treatment remain challenging due to the nonspecificity of symptoms and the diversity of clinical cases. In this regard, the problem of start time and choice of antifungal therapy remains of current interest. This review briefly describes diagnostic criteria, challenges associated with IFIs diagnosing, provides evidence for empiric and preventive strategies as two early treatment approaches, and examines the impact of therapy initiation on patient outcomes. Treatment of IFIs in hematologic patients should be individualized. At the same time, early administration of therapy with broad-spectrum drugs for febrile neutropenia and parallel diagnostic measures can improve treatment outcomes. There is a lack of current data on the benefits of specific treatment strategies, highlighting the need for further research.

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Section: Beta-d-glucanmentioning

confidence: 99%

“…However, in addition to a long list of reasons for false-positive results, the use of the assay has limitations regarding the access to testing and a lack of a clear threshold for positivity in children. 8 In a large multinational observational cohort study including 500 pediatric patients (70% immunocompromised, 20% with intestinal failure), various diagnostic tools for the early detection of invasive candidiasis were compared. 9 Samples were taken in at-risk patients with signs concerning for invasive candidiasis.…”

Section: Beta-d-glucanmentioning

confidence: 99%