진균혈증의 진단에 있어서 혈청 (1→3)-β-D-glucan 측정의 유용성

Abstract

Background:Early recognition of fungemia is essential for successful treatment. However, methods to culture fungus specimen taken from fungemia patients are difficult and time consuming. To assess the clincal usefulness of β-D-glucan in the detection of fungemia, we compared serum (1→3)-β-D-glucan concentrations in fungemia, bacteremia, and healthy persons. Methods:From August 2001 to October 2002, serum (1→3)-β-D-glucan concentrations were measured by turbidometric assay in 16 fungemia patients, 13 bacteremia patients and 18 healthy persons. Differences in (1→3)-β-D-glucan concentrations between fungemia patients and other groups were compared by t-test. Results:Fungemia patients were composed of 10 male and 6 female patients, and mean age was 52.9±16.2 years. The cut-off value for a positive result was 11 pg/mL. thirteen out of 16 fungemia patients had concentrations above the cul-off value (range:11.5-863 pg/mL, sensitivity:81.3%, specificity:100%), and mean concentration in fungemia was 217.8±273.8 pg/mL. Mean concentration in bacteremia was 0.1±0.3 pg/mL, and all the patients with bacteremia had the concentrations below the cut-off value. Mean concentration in the healthy persons was 0 pg/mL and all healthy persons had concentration below the cut-off value. The concentration in fungemia was statistically significantly higher than those of the other two groups(p-value: respectively 0.006, 0.006) Conclusion:We concluded that serum (1→3)-β-D-glucan is useful for the diagnosis of fungemia. Further study on the usefullness of serum (1→3)-β-D-glucan for early detection of fungemia and therapeutic monitoring is warranted.