Comparative Analysis of the Wako β-Glucan Test and the Fungitell Assay for Diagnosis of Candidemia and Pneumocystis jirovecii Pneumonia
Comparative Analysis of the Wako β-Glucan Test and the Fungitell Assay for Diagnosis of Candidemia and Pneumocystis jirovecii Pneumonia
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DOI：
10.1128/jcm.00464-18
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发表时间：
2018-09-01
影响因子：
9.4
通讯作者：
Held, Juergen
中科院分区：
文献类型：
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作者：
Friedrich, Ricarda;Rappold, Elfriede;Held, Juergen
（1 -> 3）-β-D-葡聚糖（BDG）是侵袭性真菌病的生物标志物。到目前为止，西半球的所有BDG数据都是使用Fungitell检测（FA）获得的。它与最近在欧洲推出的和子β-葡聚糖测试（GT）相比如何，在很大程度上是未知的。我们进行了一项病例对照研究，比较两种检测方法在120例念珠菌血症和63例耶氏肺孢子虫肺炎（PCP）患者的血清样本。200例菌血症或血培养阴性患者作为念珠菌血症对照组。在念珠菌血症患者中，FA和GT的中位BDG值分别为351和8.4 pg/ml。两种方法检测的念珠菌血症患者BDG水平均显著高于对照组（P < 0.001）。FA和GT诊断念珠菌血症的敏感性、特异性、阳性预测值和阴性预测值分别为86.7%、85.0%、6.0%和99.8%和42.5%、98.0%、19.0%和99.4%。在PCP患者中，FA和GT的中位BDG值分别为963和57.7 pg/ml。PCP诊断的灵敏度为100%的FA和88.9%的GT。在实践中，GT被证明是强大的，适用于测试单个样品，而出于经济原因，FA要求样品进行批量测试。FA的灵敏度上级于GT。然而，GT是FA的有价值的替代品，特别是对于疑似PCP的患者和低样本通量的实验室。
(1 -> 3)-beta-D-Glucan (BDG) is a biomarker for invasive fungal disease. Until now, all BDG data in the Western Hemisphere were obtained using the Fungitell assay (FA). How it compares to the Wako beta-glucan test (GT), which was recently launched in Europe, is largely unknown. We conducted a case-control study to compare the two assays in serum samples from 120 candidemia and 63 Pneumocystis jirovecii pneumonia (PCP) patients. Two hundred patients with bacteremia or negative blood cultures served as candidemia control group. In patients with candidemia the median BDG values of the FA and the GT were 351 and 8.4 pg/ml, respectively. With both assays, the BDG levels in candidemia were significantly higher than those measured in the control group (P < 0.001). The sensitivity, specificity, and positive and negative predictive values for the diagnosis of candidemia were 86.7%, 85.0%, 6.0%, and 99.8% for the FA and 42.5%, 98.0%, 19.0%, and 99.4% for the GT, respectively. In PCP patients the median BDG values of the FA and the GT were 963 and 57.7 pg/ml, respectively. The sensitivities for PCP diagnosis were 100% for the FA and 88.9% for the GT. In practical terms, the GT proved to be robust and applicable for testing single samples, whereas for economic reasons the FA required the samples to be tested in batch. The sensitivity of the FA is superior to that of the GT. However, the GT is a valuable alternative to the FA, especially for patients with suspected PCP and in laboratories with low sample throughput.