The detection of Aspergillus antigen (galactomannan) is considered a reliable marker for the diagnosis of invasive aspergillosis (IA), yet the sensibility and specificity of the assays commonly employed in routine are not optimal. The aim of the present study was to investigate whether the detection of another panfungal antigen, the (1,3)-b-D-glucan could have an auxiliary role in the identification of patients with IA. The study was carried out on 63 sera belonging to patients who had been screened for galactomannan, according to the clinical suspect of IA. Our data show that the positive galactomannan results were not confirmed by positive (1,3)-b-D-glucan results in patients receiving therapy with beta-lactam antibiotics associated with tazobactam, whereas in all the other cases, with the exception of four, the results of the (1,3)-b-D-glucan test were confirmatory of the galactomannan results.
Ostrosky-ZeichnerL. Invasive mycoses: Diagnostic challenges. Am J Med2012; 125:S14–S24.
2.
De PauwBE. Increasing fungal infections in the Intensive Care Unit. Surg Infect (Larchmt)2006; 7(S2):93–96.
3.
Von EiffMRoosNSchultenRHesseMZühlsdorfMvan de LooJ. Pulmonary aspergillosis: Early diagnosis improves survival. Respir Int Rev Thorac Dis1995; 62:341–47.
4.
CordonnierCPautasCMauryS. Empirical versus preemptive antifungal therapy for high-risk, febrile, neutropenic patients: A randomized, controlled trial. Clin Infect Dis2009; 48:1042–51.
5.
MaertensJTheunissenKVerhoefG. Galactomannan and computed tomography-based preemptive antifungal therapy in neutropenic patients at high risk for invasive fungal infection: A prospective feasibility study. Clin Infect Dis Off Publ Infect Dis Soc Am2005; 41:1242–50.
6.
Aguilar-GuisadoMMartín-PeñaAEspigadoIPérez de PipaonM RuizFalantesJde la CruzFCisnerosJM. Universal antifungal therapy is not needed in persistent febrile neutropenia: A tailored diagnostic and therapeutic approach. Haematologica2012;97:464–71.
7.
FarinaCPerinSAndreoniS. Evaluation of the peptide nucleic acid fluorescence in situ hybridisation technology for yeast identification directly from positive blood cultures: An Italian experience. Mycoses2012; 55:388–92.
8.
FarinaCRusselloGAndreoniS. Microarray technology for yeast identification directly from positive blood cultures. A multicenter Italian experience. Med Mycol2012; 50:549–55.
9.
MengoliCCrucianiMBarnesRALoefflerJDonnellyJP. Use of PCR for diagnosis of invasive aspergillosis: Systematic review and meta-analysis. Lancet Infect Dis2009; 9:89–96.
10.
PiniPBettuaCOrsiCF. Clinical performance of a commercial real-time PCR assay for Aspergillus DNA detection in serum samples from high-risk patients: Comparison with a galactomannan enzyme immunoassay. Eur J Clin Microbiol & Infect Dis2014, in press.
11.
LeeflangMMDebets-OssenkoppYJVisserCE. Galactomannan detection for invasive aspergillosis in immunocompromized patients. Cochrane Database Syst Rev2008; Online CD007394.
12.
ZouMTangLZhaoS. Systematic review and meta-analysis of detecting galactomannan in bronchoalveolar lavage fluid for diagnosing invasive aspergillosis. PloS One2012; 7:e43347.
13.
Ostrosky-ZeichnerLAlexanderBDKettDH. Multicenter clinical evaluation of the (1–>3) beta-D-glucan assay as an aid to diagnosis of fungal infections in humans. Clin Infect Dis Off Publ Infect Dis Soc Am2005; 41:654–59.
14.
OnishiASugiyamaDKogataY. Diagnostic accuracy of serum 1,3-β-D-glucan for Pneumocystis jiroveci pneumonia, invasive candidiasis, and invasive aspergillosis: Systematic review and meta-analysis. J Clin Microbiol2012; 50:7–15.
15.
ArdizzoniAPosteraroBBaschieriMC. An antibody reactivity-based assay for diagnosis of invasive candidiasis using protein array. Intl J Immunopathol Pharmacol2014; 27:403–12.
16.
BoonsarngsukVNiyompattamaATeosirimongkolCSriwanichrakK. False-positive serum and brochoalveolar lavage Aspergillus galactomannan assay caused by different antibotics. Scand J Infect Dis2010; 42:461–68.
17.
GerlingerMPRousselotPRigaudeauSBillonCTouratierSCastaigneSEloyO. False positive galactomannan Platelia due to piperacillin-tazobactam. Med Mal Infect2012; 42:10–14.
18.
MikulskaMFurfaroEDel BonoVRaiolaAMRattoSBacigalupoAViscoliC. Piperacillin/tazobactam (Tazocin) seems to be no longer responsible for false-positive results of the galactomannan assay. J Antimicrob Chemother2012; 67:1746–48.
19.
KedzierskaAKochanPPietrzykAKedzierskaJ. Current status of fungal cell wall components in the immunodiagnostics of invasive fungal infections in humans: Galactomannan, mannan and (1, 3)-beta-D-glucan antigens. Eur J Clin Microbiol Infect Dis2007; 26:755–66.
20.
De PauwBWalshTJDonnellyJP. Revised definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) Consensus Group. Clin Infect Dis Off Publ Infect Dis Soc Am2008; 46:1813–21.
21.
LamothFCrucianiMMengoliCCastagnolaELortholaryORichardsonMMarchettiO. Third European Conference on Infections in Leukemia (ECIL-3). B-glucan antigenemia assay for the diagnosis of invasive fungal infections in patients with hematological malignancies: A systematic review and meta-analysis of cohort studies from the Third European Conference on Infections in Leukemia (ECIL-3). Clin Infect Dis2012; 54:633–43.
22.
MarchettiOLamothFMikulskaMViscoliCVerweijPBretagneS, and European Conference on Infections in Leukemia (ECIL) Laboratory Working Groups. ECIL recommendations for the use of biological markers for the diagnosis of invasive fungal diseases in leukemic patients and hematopoietic SCT recipients. Bone Marrow Transplant2009; 47:846–54.
23.
DellingerRPLevyMMRhodesA. Surviving sepsis campaign. Crit Care Med2013; 41:580–637.
24.
Cuenca-EstrellaMVerweijPEArendrupMC. ESCMID* guideline for the diagnosis and management of Candida diseases 2012: Diagnostic procedures. Clin Microbiol Infect2012; 18:9–18.
25.
KarageorgopoulosDEVouloumanouEKNtzioraFMichalopoulosARafailidisPIFalagasME. Beta-D-Glucan Assay for the diagnosis of invasive fungal infections: A meta-analysis. Clin Infect Dis2011; 15:750–70.
26.
MetanGKoçANAtalayAKaynarLGOzturkAAlpEEserB. What should be the optimal cutoff of serum 1,3-β-D-glucan for the detection of invasive pulmonary aspergillosis in patients with haematological malignancies?Scand J Infect Dis2012;44:330–36.
27.
SulahianAPorcherRBergeronATouratierSRaffouxEMenottiJDerouinFRibaudP. Use and limits of (1–3)-β-d-Glucan Assay (Fungitell), compared to galactomannan determination (Platelia Aspergillus), for diagnosis of Invasive Aspergillosis. J Clin Microbiol2014; 52:2328–33.
28.
FontanaCGazianoRFavaroMCasalinuovoIPistoiaEDi FrancescoP. (1–3)-β-D-Glucan vs Galactomannan Antigen in Diagnosing Invasive Fungal Infections (IFIs). Open Microbiol J2012; 6:70–73.
29.
AcostaJCatalanMdel Palacio-Peréz-MedelA. A prospective comparison of galactomannan in bronchoalveolar lavage fluid for the diagnosis of pulmonary invasive aspergillosis in medical patients under intensive care: Comparison with the diagnostic performance of galactomannan and of (1→3)-β-D-glucan: Fungal biomarkers in ICU patients. Clin Microbiol Infect2011; 17:1053–60.
30.
AcostaJCatalanMPalacio-Pérez-MedelA. Prospective study in critically ill non-neutropenic patients: Diagnostic potential of (1,3)-β-D-glucan assay and circulating galactomannan for the diagnosis of invasive fungal disease. Eur J Clin Microbiol Infect Dis2012; 31:721–31.
31.
PazosCPontónJDel PalacioA. Contribution of (1->3)-beta-D-glucan chromogenic assay to diagnosis and therapeutic monitoring of invasive aspergillosis in neutropenic adult patients: A comparison with serial screening for circulating galactomannan. J Clin Microbiol2005; 43:299–305.
32.
ObayashiTNegishiKSuzukiTFunataN. Reappraisal of the serum (1–>3)-beta-D-glucan assay for the diagnosis of invasive fungal infections - a study based on autopsy cases from 6 years. Clin Infect Dis2008; 46:1864–70.
