American Journal of Internal Medicine

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Significance of G Test [(1-3)-β-D-Glucan Assay] in the Diagnosis and Guidance of Clinical Medication of Invasive Fungal Infection

Received: Apr. 13, 2019    Accepted: May 21, 2019    Published: Jun. 11, 2019
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Abstract

Objective: G test [(1-3) -β-D-glucan assay] was a novel texting method for invasive fungal infection (IFI). The study evaluated the diagnostic value of G test for IFI by comparing G test with fungal culture method,and analyze the guiding significance of G test and fungal culture in clinical medication. Methods: 373 inpatients with suspected IFI in the first affiliated hospital of Jinan university from January to December 2017 were retrospectively analyzed. G test and fungal culture results were collected, and their positive rate, sensitivity, specificity, positive and negative predictive values were calculated. The value and rationality of G test for clinical diagnosis of IFI was evaluated by taking the relief and cure of infection symptoms of patients as clinical effective criteria. Results: Among 373 suspected IFI patients, the positive rate of G experiment was 39.95%, higher than that of fungus culture (28.95%, P<0.001). The positive rate of combined G test and fungal culture was 43.70%. To evaluate the consistency of G test with fungal culture method, κ value was 0.596 (P<0.001). When positive fungal culture was used as the criterion for the diagnosis of IFI, the sensitivity, specificity, positive predictive value and negative predictive value of G test for the diagnosis of IFI were 87.04%, 79.25%, 63.09% and 93.75%, respectively. All 373 patients with IFI received antifungal therapy, and the effective rate of the both methods positive group was 72.34%, higher than 42.86% in the only fungal culture positive group (P=0.033) and 30.48% in the both methods negative group (P<0.001). The effective rate of the only G test positive group was 58.18%, higher than that of the both methods negative group (30.48%, P<0.001). There was no significant difference in the therapeutic efficiency between the only G test positive group and the only fungal culture positive group (P=0.303). Conclusion: G test was an effective diagnostic method of IFI, and combined with fungal culture could improve its positive rate and have a higher guiding value for clinical medication.

DOI 10.11648/j.ajim.20190702.15
Published in American Journal of Internal Medicine ( Volume 7, Issue 2, March 2019 )
Page(s) 46-50
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This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Invasive Fungal Infection, G Test, (1-3)-β-D-Glucan, Diagnostic Value, Fungal Culture

References
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[2] Groll, A. H. and J. Ritter, [Diagnosis and management of fungal infections and pneumocystis pneumonitis in pediatric cancer patients]. Klin Padiatr, 2005. 217 Suppl 1: p. S37-66.
[3] Denning, D. W. and P. Munoz, Advances in invasive fungal infection and antifungal therapy: Introduction. Clin Microbiol Infect, 2001. 7 Suppl 2: p. vi.
[4] Pickering, J. W., et al., Evaluation of a (1-&gt;3)-beta-D-glucan assay for diagnosis of invasive fungal infections. J Clin Microbiol, 2005. 43(12): p. 5957-62.
[5] Schuetz, A. N., Invasive fungal infections: biomarkers and molecular approaches to diagnosis. Clinics in laboratory medicine, 2013. 33(3): p. 505.
[6] Montagna, M. T., et al., Epidemiology of invasive fungal infections in the intensive care unit: results of a multicenter Italian survey (AURORA Project). Infection, 2013. 41(3): p. 645-53.
[7] Kontoyiannis, D. P., A clinical perspective for the management of invasive fungal infections: focus on IDSA guidelines. Infectious Diseases Society of America. Pharmacotherapy, 2001. 21(8 Pt 2): p. 175S-187S.
[8] Murri, R., et al., Performance evaluation of the (1, 3)-beta-D-glucan detection assay in non-intensive care unit adult patients. Infect Drug Resist, 2019. 12: p. 19-24.
[9] Yoshida, K., H. Shoji and T. Takuma, Clinical viability of fungitell, a new (1-3)-β-D-glucan measurement kit, for diagnosis of invasive fungal infection, and comparison with other kits available in Japan. J Infect Chemother., 2011. 17(4): p. 473-477.
[10] Giacobbe, D. R., et al., Combined use of serum (1, 3)-beta-D-glucan and procalcitonin for the early differential diagnosis between candidaemia and bacteraemia in intensive care units. Crit Care, 2017. 21(1): p. 176.
[11] He S, et al., A systematic review and meta-analysis of diagnostic accuracy of serum 1, 3-β-D-glucan for invasive fungal infection: Focus on cutoff levels. J Microbiol Immunol Infect., 2014. 48(4): p. 351-361.
[12] Shabaan AE, E. L. E. W., Role of serum (1, 3)-β-d-glucan assay in early diagnosis of invasive fungal infections in a neonatal intensive care unit. J Pediatr (Rio J). 2018 Sep - Oct; 94(5):559-565.
[13] Nucci, M., et al., Performance of 1, 3-beta-D-glucan in the diagnosis and monitoring of invasive fusariosis. Mycoses, 2019.
[14] Hachem, R. Y., et al., Utility of galactomannan enzyme immunoassay and (1, 3) beta-D-glucan in diagnosis of invasive fungal infections: low sensitivity for Aspergillus fumigatus infection in hematologic malignancy patients. J Clin Microbiol, 2009. 47(1): p. 129-33.
[15] Tran T, B. S., Application of the 1, 3-b-D-Glucan (Fungitell) Assay in the Diagnosis of Invasive Fungal Infections. Arch Pathol Lab Med. 2016 Feb; 140(2):181-5..
[16] Trager, J., et al., Serum (1--&gt;3)-beta-D-glucan and galactomannan levels in patients with cystic fibrosis: a retrospective cohort study. BMC Pulm Med, 2018. 18(1): p. 52.
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    Lianfang Xue, Suishan Qiu, Guangchao Yu, Qin-Ai Zhu, Shasha Li, et al. (2019). Significance of G Test [(1-3)-β-D-Glucan Assay] in the Diagnosis and Guidance of Clinical Medication of Invasive Fungal Infection. American Journal of Internal Medicine, 7(2), 46-50. https://doi.org/10.11648/j.ajim.20190702.15

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    Lianfang Xue; Suishan Qiu; Guangchao Yu; Qin-Ai Zhu; Shasha Li, et al. Significance of G Test [(1-3)-β-D-Glucan Assay] in the Diagnosis and Guidance of Clinical Medication of Invasive Fungal Infection. Am. J. Intern. Med. 2019, 7(2), 46-50. doi: 10.11648/j.ajim.20190702.15

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    AMA Style

    Lianfang Xue, Suishan Qiu, Guangchao Yu, Qin-Ai Zhu, Shasha Li, et al. Significance of G Test [(1-3)-β-D-Glucan Assay] in the Diagnosis and Guidance of Clinical Medication of Invasive Fungal Infection. Am J Intern Med. 2019;7(2):46-50. doi: 10.11648/j.ajim.20190702.15

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  • @article{10.11648/j.ajim.20190702.15,
      author = {Lianfang Xue and Suishan Qiu and Guangchao Yu and Qin-Ai Zhu and Shasha Li and Hui Liu and Yuping Wang and Fengtian Ouyang and Wenyu Gong},
      title = {Significance of G Test [(1-3)-β-D-Glucan Assay] in the Diagnosis and Guidance of Clinical Medication of Invasive Fungal Infection},
      journal = {American Journal of Internal Medicine},
      volume = {7},
      number = {2},
      pages = {46-50},
      doi = {10.11648/j.ajim.20190702.15},
      url = {https://doi.org/10.11648/j.ajim.20190702.15},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.ajim.20190702.15},
      abstract = {Objective: G test [(1-3) -β-D-glucan assay] was a novel texting method for invasive fungal infection (IFI). The study evaluated the diagnostic value of G test for IFI by comparing G test with fungal culture method,and analyze the guiding significance of G test and fungal culture in clinical medication. Methods: 373 inpatients with suspected IFI in the first affiliated hospital of Jinan university from January to December 2017 were retrospectively analyzed. G test and fungal culture results were collected, and their positive rate, sensitivity, specificity, positive and negative predictive values were calculated. The value and rationality of G test for clinical diagnosis of IFI was evaluated by taking the relief and cure of infection symptoms of patients as clinical effective criteria. Results: Among 373 suspected IFI patients, the positive rate of G experiment was 39.95%, higher than that of fungus culture (28.95%, P<0.001). The positive rate of combined G test and fungal culture was 43.70%. To evaluate the consistency of G test with fungal culture method, κ value was 0.596 (P<0.001). When positive fungal culture was used as the criterion for the diagnosis of IFI, the sensitivity, specificity, positive predictive value and negative predictive value of G test for the diagnosis of IFI were 87.04%, 79.25%, 63.09% and 93.75%, respectively. All 373 patients with IFI received antifungal therapy, and the effective rate of the both methods positive group was 72.34%, higher than 42.86% in the only fungal culture positive group (P=0.033) and 30.48% in the both methods negative group (P<0.001). The effective rate of the only G test positive group was 58.18%, higher than that of the both methods negative group (30.48%, P<0.001). There was no significant difference in the therapeutic efficiency between the only G test positive group and the only fungal culture positive group (P=0.303). Conclusion: G test was an effective diagnostic method of IFI, and combined with fungal culture could improve its positive rate and have a higher guiding value for clinical medication.},
     year = {2019}
    }
    

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  • TY  - JOUR
    T1  - Significance of G Test [(1-3)-β-D-Glucan Assay] in the Diagnosis and Guidance of Clinical Medication of Invasive Fungal Infection
    AU  - Lianfang Xue
    AU  - Suishan Qiu
    AU  - Guangchao Yu
    AU  - Qin-Ai Zhu
    AU  - Shasha Li
    AU  - Hui Liu
    AU  - Yuping Wang
    AU  - Fengtian Ouyang
    AU  - Wenyu Gong
    Y1  - 2019/06/11
    PY  - 2019
    N1  - https://doi.org/10.11648/j.ajim.20190702.15
    DO  - 10.11648/j.ajim.20190702.15
    T2  - American Journal of Internal Medicine
    JF  - American Journal of Internal Medicine
    JO  - American Journal of Internal Medicine
    SP  - 46
    EP  - 50
    PB  - Science Publishing Group
    SN  - 2330-4324
    UR  - https://doi.org/10.11648/j.ajim.20190702.15
    AB  - Objective: G test [(1-3) -β-D-glucan assay] was a novel texting method for invasive fungal infection (IFI). The study evaluated the diagnostic value of G test for IFI by comparing G test with fungal culture method,and analyze the guiding significance of G test and fungal culture in clinical medication. Methods: 373 inpatients with suspected IFI in the first affiliated hospital of Jinan university from January to December 2017 were retrospectively analyzed. G test and fungal culture results were collected, and their positive rate, sensitivity, specificity, positive and negative predictive values were calculated. The value and rationality of G test for clinical diagnosis of IFI was evaluated by taking the relief and cure of infection symptoms of patients as clinical effective criteria. Results: Among 373 suspected IFI patients, the positive rate of G experiment was 39.95%, higher than that of fungus culture (28.95%, P<0.001). The positive rate of combined G test and fungal culture was 43.70%. To evaluate the consistency of G test with fungal culture method, κ value was 0.596 (P<0.001). When positive fungal culture was used as the criterion for the diagnosis of IFI, the sensitivity, specificity, positive predictive value and negative predictive value of G test for the diagnosis of IFI were 87.04%, 79.25%, 63.09% and 93.75%, respectively. All 373 patients with IFI received antifungal therapy, and the effective rate of the both methods positive group was 72.34%, higher than 42.86% in the only fungal culture positive group (P=0.033) and 30.48% in the both methods negative group (P<0.001). The effective rate of the only G test positive group was 58.18%, higher than that of the both methods negative group (30.48%, P<0.001). There was no significant difference in the therapeutic efficiency between the only G test positive group and the only fungal culture positive group (P=0.303). Conclusion: G test was an effective diagnostic method of IFI, and combined with fungal culture could improve its positive rate and have a higher guiding value for clinical medication.
    VL  - 7
    IS  - 2
    ER  - 

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Author Information
  • Department of Pharmacy, The First Affiliated Hospital of Jinan University, Guangzhou, China

  • Department of Pharmacy, The First Affiliated Hospital of Jinan University, Guangzhou, China

  • Department of Laboratory, The First Affiliated Hospital of Jinan University, Guangzhou, China

  • Department of Laboratory, The First Affiliated Hospital of Jinan University, Guangzhou, China

  • Department of Pharmacy, The First Affiliated Hospital of Jinan University, Guangzhou, China

  • Department of Pharmacy, The First Affiliated Hospital of Jinan University, Guangzhou, China

  • Department of Pharmacy, The First Affiliated Hospital of Jinan University, Guangzhou, China

  • College of Pharmacy, Jinan University, Guangzhou, China

  • Department of Nephrology, The First Affiliated Hospital of Jinan University, Guangzhou, China

  • Section