Diagnostic potential of (1,3)-beta-D-glucan and anti-Candida albicans germ tube antibodies for the diagnosis and therapeutic monitoring of invasive candidiasis in neutropenic adult patients.

Abstract	The usefulness to diagnose and monitor invasive candidiasis (IC) using beta-glucan (BG) and antibodies against Candida albicans germ tubes (CAGT) was evaluated in a twice-weekly screening of 35 episodes in neutropenic adults at high risk. Three proven IC and three probable IC were assessed. Diagnostic levels of both markers were detected in 100% of proven IC and in 66% of probable IC. Sensitivity, specificity, positive and negative predictive values of BG and anti-CAGT antibodies detection were 83.3%, 89.6%, 62.5% and 96.3%, and 83.3%, 86.2%, 55.5%, 96.1%, respectively. False positive reactions occurred at a rate of 10.3% and 13.8% for the detection of BG and anti-CAGT antibodies, respectively. However, the patients with false positive results were different by each test. Both tests anticipated the clinical and radiological diagnosis, and the initiation of antifungal therapy in most patients. Combination of both tests improved specificity and positive predictive value to 100%.
Authors	Carmen Pazos, María-Dolores Moragues, Guillermo Quindós, José Pontón, Amalia del Palacio
Journal	Revista iberoamericana de micologia (Rev Iberoam Micol) Vol. 23 Issue 4 Pg. 209-15 (Dec 2006) ISSN: 1130-1406 [Print] Spain
PMID	17388644 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)
Chemical References	Antibodies, Fungal Antifungal Agents Antigens, Fungal Liposomes beta-Glucans liposomal amphotericin B Amphotericin B Fluconazole beta-1,3-glucan
Topics	Adolescent Adult Aged Amphotericin B (therapeutic use) Anemia, Aplastic (complications) Antibodies, Fungal (blood, immunology) Antibody Specificity Antifungal Agents (therapeutic use) Antigens, Fungal (immunology) Candida albicans (immunology) Candidiasis (diagnosis, etiology, immunology) False Positive Reactions Female Fluconazole (therapeutic use) Fungemia (diagnosis, etiology, immunology) Hematologic Neoplasms (complications) Hepatitis (diagnosis, etiology, immunology, microbiology) Humans Liposomes (administration & dosage) Male Middle Aged Neutropenia (complications) Patient Isolation Predictive Value of Tests Sensitivity and Specificity beta-Glucans (immunology)

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