The Value Of Circulating Galactomanna Detection For The Diagnosis Of Penicilliosis Marneffei

Objective:To evaluate the serum galactomannan (GM) test of penicilliosis marneffei in the diagnosis and the sensitivity and specificity of the comparison of different cut-off and to determine the optimal cut-off value of the PSM serum GM test.Methods:To collect 31 serums of patients of penicilliosis marneffei from the first affiliated hospital of Guangxi Medical University and the Baise people’s hospital during 2012 to 2015 and 30 serums of healthy volunteers of no fungal infection. The study detect the levels of serum GM through Double-Antibody Sandwich ELISA and evaluate effective of the GM test for the diagnosis of PSM and compare sensitivity,specificity and youden index of different cut-off. According to the result of the experiment to select the optimal value. Through to draw the ROC curves of GM test in diagnosis of HIV infection combined with PSM, not with HIV infection of PSM and all PSM, compare areas under the ROC curves and verify the accuracy of diagnosis is meaningful. Through the observation the change of GM level of return visit patients, observe of GM test for antifungal therapy prognosis monitoring effect.Results:The optimal cuf-off is 0.5 for GM test in the diagnosis of PSM, the Youden index of 60.47%, the sensitivity of 83.87%, specificity of 76.6%. The optimal cut-off is 1.5 for GM test in the diagnosis of HIV infection combined with PSM, the sensitivity 90.91%, specificity of 97.87%. Comparison of area under ROC curve, the GM test for the diagnosis of PSM combined with HIV infection efficiency was significantly higher than no with HIV infection and PSM. Area GM test ROC curve of HIV infection combined with PSM ACU=0.987, illustrate the diagnostic accuracy is very high, the accuracy of diagnosis of no HIV infection combined with PSM and all PSM is lower, but it still has certain accuracy. To observe return visit of GM test cases, compare of test results the GM test of PSM within 1 weeks results and 1 weeks later. The condition of PSM patients were improved through anti fungus drugs after 1 weeks of treatment and GM values decreased. Monitoring method of the GM test can be used as PSM antifungal treatment effect.Conclusion:The GM test can be used as the index in the diagnosis of PSM, especially the diagnosis efficiency is quite high for PSM combined with HIV infection, and has an important significance forearly diagnosis of HIV infection and PSM epidemic area. The concentration of GM was positively correlated with the degree of infection, can be used to evaluate the efficacy of PSM after antifungal therapy. Continuous detection of GM, can monitor the changes. The method is better than the traditional method for diagnosis of fungal culture, and was more rapid.