Clinical Significance Of Plasma (1→3)-β-D-glucan In Patients Suspected With Deep Fungal Infection

Objective Plasma(1→3)-β-D-glucan is a widely antigenic component of cell wall,whereas there is nothing in others microbe and persons' cell components.Blood plasma (1→3)-β-D-glucan is significantly higher in deep fungal infection and there is some relation between them.62 in-patients suspected deep fungal infection with fever and 13 in-health volunteers are detected.To study the Clinical significance of blood plasma (1→3)-β-D-glucan measurement in diagnosis of deep fungal infection.To assess the sensitivity and specificity of blood plasma(1→3)-β-D-glucan.To understand the relation between blood plasma(1→3)-β-D-glucan and MDRA score.MethodsContent of blood plasma(1→3)-β-D-glucan were measured by Microbiology Kinetic Rapid Reader MB-80 within 62 in-patients suspected deep fungal infection with fever(2007.4-2007.12)in the First Affiliated Hospital of China Medical University and 13 in-health volunteers.At the same time to detect blood culture and test under microscope.Results1,Of the 62 patient,14 cases were proven deep fungal infection;whereas 12 cases were probable deep fungal infection,15 cases were high risk to be deep fungal infection and 21 cases were bacterium septicaemia.Mean blood plasma(1→3)-β-D-glucan of the healthy volunteers is 6.65±1.01pg/ml and in deep fungal group,the result is 105.02±82.22 pg/ml,the probable group'result is 8.35±4.32pg/ml pg/ml and the result of the high risk group is 13.44±16.52 pg/ml.The bacterium septicaemia group'result is 8.43±6.32pg/ml. 2,In the study group,T-test analysis indicates the mean serum content of deep fungal group and the healthy group have notable difference(t=4.307,P＜0.01).The other three groups have no difference with the healthy group(t=1.327,1.475,1.003,P＞0.05, 0.05,0.05).The result of the deep fungal group have notable difference with the other three groups in the study group(t=4.056,4.229,5.4,P＜0.01,0.01,0.01).There is no difference among the last three groups(t=-1.035,-0.045,1.27,P＞0.05).3,Based on the content of 20pg/ml,blood plasma(1→3)-β-D-glucan showed accurate rate,sensitivity,specificity of 90.32%,92.86%,89.58%respectively.4,The relation between blood plasma(1→3)-β-D-glucan and MDRA score is not linear correlation.5,Most fungal infections are due to Candida species.Conclusions1,Candida is the common pathogenic bacteria,however,non-Candida albicansis infect is raising obviously.2,The safety method of blood plasma(1→3)-β-D-glucan can conform completely Candida Albicans,Aspergillus.3,Blood plasma(1→3)-β-D-glucan≥20pg/ml,that is the diagnosis limit of high sensitivity,specificity.4,Blood plasma(1→3)-β-D-glucan had been a promising aid in rapid,early diagnosis of deep fungal infection and could not take place of pathogenic microorganism tests.5,For the probable group,Blood plasma(1→3)-β-D-glucan is a promising aid in diagnosis of deep fungal infection.6,The serum concentrations of(1→3)-β-D-glucan were significantly higher in high risk group,it had been the important index of deep fungal infection.7,Blood plasma(1→3)-β-D-glucan is low in bacterium septicaemia group which is different between deep fungal infection and bacterium septicaemia.When it has been rising,that means the possible of deep fungal infection. 8,MDRA score is not the diagnosis index of deep fungal infection,but which can predict the risk of deep fungal infection.