Beta-l,3-D-Glucan (BGL) Antigenemia in Neutropenic Cancer Patients (Pts) with Invasive Aspergillosis (IA) and Candidiasis (IC)

L. Senn*, J.O. Robinson, S. Schmidt, M. Knaup, N. Asahi, S. Satomura, S. Matsuura, B. Duvoisin, T. CaLandra, O. Marchetti.

Author address: 

Infectious Diseases Service, CHUV, Lausanne, Switzerland

Abstract: 

Background: IA and IC are associated with high morbidity and mortality in neutropenic cancer pts. New diagnostic tests are needed for early diagnosis of invasive mycosis. BGL, a fungaL ceLL waLL antigen, can be detected in the systemic circulation of pts with IA or IC. Objectives: To eval,uate the util,ity of BGL monitoring in neutropenic cancer pts at high risk of IA and IC. Methods: Prospective study of consecutive episodes of neutropenia (median duration 22 d) in pts with acute l,eukemia. IA and IC were defined according to EORTC-MSG criteria. Bl,ood was col,l,ected 2 times weekl,y before onset of fever and dail,y thereafter. BGL was measured by turbidimetric or col,orimetric assays (Wako, Japan). Positive tests defined by 2 consecutive BGL val,ues >6 and >5 pg/ml,, or >11 pg/ml, for both tests (2 cut-off val,ues). Results: 23 episodes of invasive mycoses occurred during 130 neutropenic episodes: 12 IC (1 proven, 11 probabl,e) and 11 IA (3 proven, 8 probabl,e). 16 sampl,es/episode (3-35) were anal, yzed over 35 days (17-122). Diagnostic performance of BGL (turbidimetric test): sensitivity, specificity, PPV, NPV, negative l,ikel,ihood ratio were 43/100/100/86/0.57% and 24/100/100/82/0.76% for 2 consecutive val,ues >6 and >11, respectivel, y. Diagnostic performance of BGL (col,orimetric test): sensitivity, specificity, PPV, NPV, negative l,ikel,ihood ratio were 86/91/72/96/0.15% and 43/100/100/86/0.57% for 2 consecutive val,ues >5 and >11, respectivel,y. Col,orimetric BGL with cut-off of 2 consecutives val,ues >5 provided the best performance for diagnosis of IA and IC. Median time (0d) between fever onset (as first sign of IFI) and BGL positivity was significantl,y shorter than that between fever onset and conventional. diagnosis of IFI (13d) (p
2006

abstract No: 

S112

Full conference title: 

14th International Symposium of Infections in the Immunocompromised Host
    • ISIIH, 14th