(1,3)-beta-D-glucan is able to predict therapeutic failure of patients with candidemia and not only mortality

Autor(es)

Esteves, Patricia ^[1] ; Lopes Lima, Soraia ^[1] ; Salles de Azevedo Melo, Analy ^[1] ; Maria Beirao, Elisa ^[1] ; Nucci, Marcio ^[2] ; Colombo, Arnaldo L. ^[1]

Afiliação do(s) autor(es)

^[1] Univ Fed Sao Paulo UNIFESP, Div Infect Dis, Dept Med, Sao Paulo - Brazil

^[2] Univ Fed Rio de Janeiro, Univ Hosp, Dept Internal Med, Rio De Janeiro - Brazil

• Tipo de documento: Artigo Científico
• Fonte: MYCOSES; v. 64, n. 3 DEC 2020.
• Citações Web of Science: 0

Resumo

Background: Candidemia is a major cause of bloodstream infection in tertiary hospitals worldwide and fungal biomarkers may provide early diagnosis. Objectives: To evaluate the performance of (1-3)-beta-D-glucan (BDG) in the diagnosis of candidemia and its ability to predict therapeutic failure. Patients and Method: This was a prospective, multi-centre study conducted in 3 Brazilian hospitals. Clinical outcome was evaluated along 2 weeks of treatment, and therapeutic failure was defined as the occurrence of persistent candidemia, Candida deep-seated infection or death. Baseline BDG detection was performed with the Fungitell(R) assay (Associates of Cape Cod, Falmouth-USA). Results: We enrolled a total of 71 patients with candidemia and a control group with 110 healthy volunteers. The sensitivity and specificity of BDG for diagnosing candidemia were as follows: 71.8% (95% confidence interval {[}95% CI] 59.7% - 81.5%) and 98.2% (95% CI 92.9% - 99.7%), respectively. The only predictor of therapeutic failure was a higher BDG value at diagnosis of candidemia; a value > 226 pg/mL predicted failure with sensitivity and specificity of 75% and 78%, respectively. Conclusions: A high baseline serum BDG value was associated with therapeutic failure. (AU)

• Processo FAPESP: 17/02203-7 - Rede multidisciplinar internacional para caracterização de aspectos microbiológicos e da história natural de Infecções Fúngicas Invasivas (IFI) por espécies do gênero Candida
• Beneficiário: Arnaldo Lopes Colombo
• Modalidade de apoio: Auxílio à Pesquisa - Temático