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- Titel:
Usage of 1,3-?-D-Glucan for Early Detection of Invasive Mycoses and Outcome Parameter in Immunocompromised Critically Ill Patients.
- Dokumenttyp:
- Journal Article
- Autor(en):
- Lahmer, Tobias; Held, Jürgen; Rasch, Sebastian; Schnappauf, Christopher; Beitz, Analena; Schmid, Roland M; Huber, Wolfgang
- Abstract:
- Invasive fungal disease (IFD) remains a significant cause of morbidity and mortality in critically ill patients.Examination of 1,3-?-D-glucan (BDG) for IFD and as outcome parameter in immunocompromised critically ill patients with septic shock.Thirty-two (69 %) out of 46 included patients had BDG beyond the cutoff of >80 pg/ml (mean 320 pg/ml). Twelve (37 %) had findings of Aspergillus spp. in BAL (mean BDG 413 pg/ml). EORTC/MSG guidelines classified these as probable invasive aspergillosis (IA)/IFD. Five (16 %) had candidaemia (mean BDG level 361 pg/ml). Sensitivity of 78 % (95 % CI 58-88 %) and specificity of 68 % (95 % CI 52-77 %) for IFD were found on the BDG Fungitell assay. In detail, a sensitivity of 73 % (95 % 58-84 %) and specificity of 83 % (95 % CI 68-93 %) for IA and a sensitivity of 77 % (CI 95 % 62-87 %) and specificity 53 % (95 % CI 37-73 %) for candidaemia were found. APACHE II, SOFA score and mortality rate were in the elevated BDG group significantly altered (26 vs. 21, p < 0.003; 15 vs. 13, p < 0.006; 72 vs. 50 %, p < 0.004).1,3-?-D-glucan assay is helpful for early detection of IFD; moreover, elevated BDG levels can be used as a predictor for outcome in immunocompromised critically ill patients as presented in our study.
- Zeitschriftentitel:
- Mycopathologia
- Jahr:
- 2016
- Band / Volume:
- 181
- Heft / Issue:
- 11-12
- Seitenangaben Beitrag:
- 815-821
- Sprache:
- eng
- Volltext / DOI:
- doi:10.1007/s11046-016-0061-0
- PubMed:
- http://view.ncbi.nlm.nih.gov/pubmed/27619810
- Print-ISSN:
- 0301-486X
- TUM Einrichtung:
- II. Medizinische Klinik und Poliklinik (Gastroenterologie)
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