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Int. J. Mol. Sci. 2017, 18(4), 862; doi:10.3390/ijms18040862

Detection of (1,3)-β-d-Glucan for the Diagnosis of Invasive Fungal Infection in Liver Transplant Recipients

1
Department of Anaesthesia and Surgical Intensive Care-Liver ICU, AP-HP Henri Mondor Hospital, 51 Avenue du Marechal de Lattre de Tassigny, 94100 Créteil, France
2
INSERM, Unit U955, 94100 Creteil, France
3
Mycology Unit–Microbiology department, DHU “Virus, Immunité, Cancer” VIC, AP-HP Henri Mondor Hospital, 94100 Creteil, France
4
EA Dynamyc Université Paris-Est Créteil (UPEC), Ecole National Vétérinaire d’Alfort (ENVA), Faculté de Médecine de Créteil, 8 rue du Général Sarrail, 94010 Créteil, France
5
Pharmacy Unit, AP-HP Henri Mondor Hospital, 51 Avenue du Maréchal De Lattre de Tassigny, 94010 Créteil, France
6
Digestive Surgery and Liver Transplant Unit, AP-HP Henri Mondor Hospital, 94100 Créteil, France
*
Author to whom correspondence should be addressed.
Academic Editor: Vaclav Vetvicka
Received: 15 February 2017 / Revised: 11 April 2017 / Accepted: 13 April 2017 / Published: 19 April 2017
(This article belongs to the Special Issue Glucan: New Perspectives on Biochemistry and Application)
View Full-Text   |   Download PDF [695 KB, uploaded 19 April 2017]   |  

Abstract

Invasive fungal infections (IFI) are complications after liver transplantation involving high morbidity and mortality. (1,3)-β-d-glucan (BG) is a biomarker for IFI, but its utility remains uncertain. This study was designed to evaluate the impact of BG following their diagnosis. Between January 2013 and May 2016, 271 liver transplants were performed in our institution. Serum samples were tested for BG (Fungitell®, Associates Cape Code Inc., Falmouth, MA, USA) at least weekly between liver transplantation and the discharge of patients. Nineteen patients (7%) were diagnosed with IFI, including 13 cases of invasive candidiasis (IC), eight cases of invasive pulmonary aspergillosis, and one case of septic arthritis due to Scedosporium apiospernum. Using a single BG sample for the primary analysis of IFI, 95% (21/22) of the subjects had positive BG (>80 pg/mL) at the time of IFI diagnosis. The area under the ROC curves to predict IFI was 0.78 (95% CI: 0.73–0.83). The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of BG for IFI were 75% (95% CI: 65–83), 65% (62–68), 17% (13–21), and 96% (94–97), respectively. Based on their high NPV, the BG test appears to constitute a good biomarker to rule out a diagnosis of IFI. View Full-Text
Keywords: (1,3)-β-d-glucan; invasive fungal infection; liver transplantation; invasive pulmonary aspergillosis; invasive candidiasis (1,3)-β-d-glucan; invasive fungal infection; liver transplantation; invasive pulmonary aspergillosis; invasive candidiasis
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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Levesque, E.; Rizk, F.; Noorah, Z.; Aït-Ammar, N.; Cordonnier-Jourdin, C.; El Anbassi, S.; Bonnal, C.; Azoulay, D.; Merle, J.-C.; Botterel, F. Detection of (1,3)-β-d-Glucan for the Diagnosis of Invasive Fungal Infection in Liver Transplant Recipients. Int. J. Mol. Sci. 2017, 18, 862.

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