Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 May;22(5):364-368.
doi: 10.4103/ijccm.IJCCM_4_18.

Experience with β-D-Glucan Assay in the Management of Critically ill Patients with High Risk of Invasive Candidiasis: An Observational Study

Nitin Bansal  1 , Ram Gopalakrishnan  1 , Nandini Sethuraman  2 , Nagarajan Ramakrishnan  3 , P Senthur Nambi  1 , D Suresh Kumar  1 , R Madhumitha  1 , M A Thirunarayan  2 , V Ramasubramanian  1
Affiliations

Experience with β-D-Glucan Assay in the Management of Critically ill Patients with High Risk of Invasive Candidiasis: An Observational Study

Nitin Bansal et al. Indian J Crit Care Med. 2018 May.

Abstract

Background: The (1,3)-β-D-glucan assay (BDG) is recommended for the early diagnosis of invasive candidiasis (IC).

Methods: Records of 154 critically ill adults with suspected IC, on whom BDG was done, were analyzed. Patients were divided into three groups: Group A (confirmed IC), Group B (alternative diagnosis or cause of severe sepsis), and Group C (high candidal score and positive BDG [>80 pg/mL] but without a confirmed diagnosis of IC).

Results: Mean BDG levels were significantly higher in Group A (n = 32) as compared to Group B (n = 60) and Group C (n = 62) (448.75 ± 88.30 vs. 144.46 ± 82.49 vs. 292.90 ± 137.0 pg/mL; P < 0.001). Discontinuation of empiric antifungal therapy based on a value <80 resulted in cost savings of 14,000 INR per day per patient.

Conclusion: A BDG value of <80 pg/ml facilitates early discontinuation of empirical antifungal therapy, with considerable cost savings.

Keywords: Antifungal stewardship; invasive candidiasis; β-D-glucan.

PubMed Disclaimer

Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Mean candidal score across the three groups
Figure 2
Figure 2
Mean (1,3)-β-d-glucan values across the three groups
Figure 3
Figure 3
Receiver operating curve showing trend of sensitivity and specificity in this study
See this image and copyright information in PMC

References

    1. CAVA I Study Group. González de Molina FJ, León C, Ruiz-Santana S, Saavedra P. Assessment of candidemia-attributable mortality in critically ill patients using propensity score matching analysis. Crit Care. 2012;16:R105. - PMC - PubMed
    1. Chakrabarti A, Sood P, Rudramurthy SM, Chen S, Kaur H, Capoor M, et al. Incidence, characteristics and outcome of ICU-acquired candidemia in India. Intensive Care Med. 2015;41:285–95. - PubMed
    1. Clancy CJ, Nguyen MH. Finding the “missing 50%” of invasive candidiasis: How nonculture diagnostics will improve understanding of disease spectrum and transform patient care. Clin Infect Dis. 2013;56:1284–92. - PubMed
    1. Azoulay E, Dupont H, Tabah A, Lortholary O, Stahl JP, Francais A, et al. Systemic antifungal therapy in critically ill patients without invasive fungal infection. Crit Care Med. 2012;40:813–22. - PubMed
    1. Ostrosky-Zeichner L, Alexander BD, Kett DH, Vazquez J, Pappas PG, Saeki F, et al. Multicenter clinical evaluation of the (1→3) beta-D-glucan assay as an aid to diagnosis of fungal infections in humans. Clin Infect Dis. 2005;41:654–9. - PubMed