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Performance of serum (1,3)‐ß‐ d ‐glucan screening for the diagnosis of invasive aspergillosis in neutropenic patients with haematological malignancies
Author(s) -
Furfaro Elisa,
Giacobbe Daniele Roberto,
Del Bono Valerio,
Signori Alessio,
Guolo Fabio,
Minetto Paola,
Clavio Marino,
Ballerini Filippo,
Gobbi Marco,
Viscoli Claudio,
Mikulska Malgorzata
Publication year - 2018
Publication title -
mycoses
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.13
H-Index - 69
eISSN - 1439-0507
pISSN - 0933-7407
DOI - 10.1111/myc.12787
Subject(s) - galactomannan , aspergillosis , medicine , gastroenterology , immunology
Summary We report our experience with the use of (1,3)‐ß‐ d ‐glucan ( BDG ) screening for the diagnosis of invasive aspergillosis ( IA ) in neutropenic patients with haematological malignancies. The performance of BDG screening was assessed retrospectively in per patient and per sample analyses. Overall, 20 among 167 patients developed IA (12%). In the per patient analysis, BDG showed 60% sensitivity and 78% specificity when the criterion for positivity was the presence of at least one BDG value ≥80 pg/mL. For 2 consecutive positive results, sensitivity decreased to 40%, while specificity increased to 93% and was similar to that of a positive galactomannan ( GM ; 90%). The highest specificity (97%) was observed for combined positivity of at least one BDG and at least one GM . In the per sample analysis, the specificity of BDG was 100% in the best scenario, 96% in the median scenario and 89% in the worst scenario. BDG became positive before GM in 33% of IA patients with both markers positive (n = 12). Despite good specificity for 2 consecutive positive results, the BDG test offered unsatisfactory performance for the diagnosis of IA due to low sensitivity. The combination of BDG and GM showed the potential for increasing specificity.