1562. Diagnostic Performance of the (1–3)-β-D-Glucan Assay in Pneumocystitis jirovecii, Invasive Aspergillosis, Mucormycosis, Tuberculosis and Healthy Volunteers
Session: Poster Abstract Session: Mycology: Diagnostic
Friday, October 28, 2016
Room: Poster Hall

Background: The diagnosis of Pneumocystis pneumonia (PCP) relies on microscopic visualization of Pneumocystis jirovecii or DNA detection in respiratory specimens, which needs invasive procedure such as bronchoalveolar lavage. The (1–3)-beta-D-glucan (BG) assay has been proposed as a less invasive and inexpensive diagnostic test to rule out PCP. We thus compared the blood level of BG in patients with PCP, invasive aspergillosis, mucormycosis, and tuberculosis and healthy volunteers.

Methods: All adult patients who were diagnosed with PCP, invasive aspergillosis, and mucormycosis whose blood samples were available were enrolled in a tertiary hospital in Seoul, South Korea, between January 2015 and December 2015. In addition, blood samples were obtained from healthy volunteers and from randomly-selected patients with TB whose stored blood samples during the study period were available. The Goldstream Fungus (1–3)-beta-D-glucan test (Era Biology Engineering Co., Ltd, Tianjin, China) was performed by using these blood samples.

Results: A total 83 patients with 49 P. jirovecii, 9 invasive aspergillosis, 6 mucormycosis and 19 controls including 9 patients with tuberculosis and 10 healthy volunteers were included in the analysis. The median BG level in patients with PCP was significantly higher than in those with invasive aspergillosis, with mucormycosis, with tuberculosis, and healthy volunteers, respectively (Figure 1). At a cut-off value of > 32 pg/mL, which is high sensitivity at the expense of specificity for PCP versus TB plus healthy volunteers, the BG assay had a sensitivity of 92% (95% CI 80%-98%) and a specificity of 47% (95% CI 24%-71%). At a cut-off value of > 60 pg/mL on the basis of the manufacturer¡¯s recommendation, the BG assay had a sensitivity of 86% (95% CI 73%-94%) and a specificity of 58% (95% CI 34%-80%).

Conclusion: The BG assay appears to be a useful adjunct test for diagnosing PCP.

 Table1.JPG

Figure1.JPG

Hyo-Ju Son, MD1, Heungsup Sung, MD, PhD2, Se Yoon Park, MD3, Taeeun Kim, MD3, Hyun-Jeong Lee, RN/Associate's Degree3, Sun-Mi Kim, bachelor's degree3, Yong Pil Chong, MD4, Sang-Oh Lee, MD4, Sang-Ho Choi, MD4, Yang Soo Kim, MD4, Jun Hee Woo, MD4 and Sung-Han Kim, MD4, (1)Departments of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea, The Republic of, (2)Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea, (3)Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea, (4)Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea, The Republic of

Disclosures:

H. J. Son, None

H. Sung, None

S. Y. Park, None

T. Kim, None

H. J. Lee, None

S. M. Kim, None

Y. P. Chong, None

S. O. Lee, None

S. H. Choi, None

Y. S. Kim, None

J. H. Woo, None

S. H. Kim, None

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