Performance of serum (1,3)-ß-d-glucan screening for the diagnosis of invasive aspergillosis in neutropenic patients with haematological malignancies

Elisa Furfaro, Daniele Roberto Giacobbe, Valerio Del Bono, Alessio Signori, Fabio Guolo, Paola Minetto, Marino Clavio, Filippo Ballerini, Marco Gobbi, Claudio Viscoli, Malgorzata Mikulska

Research output: Contribution to journalArticlepeer-review

Abstract

We report our experience with the use of (1,3)-ß-d-glucan (BDG) screening for the diagnosis of invasive aspergillosis (IA) in neutropenic patients with haematological malignancies. The performance of BDG screening was assessed retrospectively in per patient and per sample analyses. Overall, 20 among 167 patients developed IA (12%). In the per patient analysis, BDG showed 60% sensitivity and 78% specificity when the criterion for positivity was the presence of at least one BDG value ≥80 pg/mL. For 2 consecutive positive results, sensitivity decreased to 40%, while specificity increased to 93% and was similar to that of a positive galactomannan (GM; 90%). The highest specificity (97%) was observed for combined positivity of at least one BDG and at least one GM. In the per sample analysis, the specificity of BDG was 100% in the best scenario, 96% in the median scenario and 89% in the worst scenario. BDG became positive before GM in 33% of IA patients with both markers positive (n = 12). Despite good specificity for 2 consecutive positive results, the BDG test offered unsatisfactory performance for the diagnosis of IA due to low sensitivity. The combination of BDG and GM showed the potential for increasing specificity.

Original languageEnglish
Pages (from-to)650-655
Number of pages6
JournalMycoses
Volume61
Issue number9
DOIs
Publication statusPublished - Sep 1 2018

Keywords

  • biomarker
  • haematology
  • invasive fungal disease
  • neutropenia
  • screening

ASJC Scopus subject areas

  • Dermatology
  • Infectious Diseases

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