Which biomarkers help to distinguish between Candida and Aspergillus in patients with pulmonary infections?

Abstract

This study was an evaluation of differences in the inflammatory markers of Creactive protein (CRP) level, the neutrophil-to-lymphocyte ratio (NLR), the platelet countto-mean platelet volume ratio (PLT/MPV), and the platelet-to-lymphocyte ratio (PLR) in patients with pulmonary candidiasis and pulmonary aspergillosis. Methods: A retrospective, cross-sectional study was performed with the data of patients who were diagnosed with pulmonary candidiasis and pulmonary aspergillosis between 2016 and 2017 according to the records of the hospital information system. The results and date of hemograms, the biochemistry values, and C-reactive protein (CRP) levels were recorded. The NLR, PLT/MPV, and PLR were calculated. The documented parameters of the study groups were compared and analyzed. Results: There were 44 patients (29 men) (candidiasis, n=19; aspergillosis, n=25), with a median age of 65 years. In both groups, the incidence of chronic obstructive pulmonary disease, level of CRP, and the NLR, PLR, MPV, and PLT/MPV were statistically similar. At discharge, the CRP, PLR, NLR, and PLT values were still similar in the 2 groups; however, the MPV was significantly lower in the pulmonary aspergillosis group when compared with the pulmonary candidiasis group (7.3 vs 8.4; p=0029). Conclusion: Most biomarkers were similar in the pulmonary aspergillosis and the candidiasis groups; however, a PLT elevation and an MPV decrease were significant in the diagnosis of aspergillus. Similar findings in prospective, multicenter studies performed with patients who are suspected of having a fungal lung infection will add to the ultimate determination of the value to be given to PLT and MPV biomarkers in the initiation of empirical treatment.