caa a22 4500 606157735 CHVBK 20210128100615.0 cr unu---uuuuu 210128e20150201xx s 000 0 eng 10.1007/s10096-014-2239-z doi (NATIONALLICENCE)springer-10.1007/s10096-014-2239-z Interference of confounding factors on the use of (1,3)-beta-D-glucan in the diagnosis of invasive candidiasis in the intensive care unit [Elektronische Daten] [G. Lo Cascio, R. Koncan, G. Stringari, A. Russo, A. Azzini, A. Ugolini, M. Ligozzi, E. Polati, G. Cornaglia, E. Concia, V. Schweiger] Invasive fungal infections (IFIs) are an increasing problem in intensive care units (ICUs), and conventional diagnostic methods are not always reliable or timely enough to deliver appropriate antimicrobial therapy. The dosage of fungal antigens in serum is a promising diagnostic technique, but several confounding factors, such as treatment with immunoglobulins (Ig), albumin, or antifungals, could interfere with the correct interpretation of the (1,3)-beta-D-glucan (BG) assay. This study assessed the reliability of the BG assay and the influence of timing and dosage of major confounding factors on circulating levels of IFI biomarkers. 267 ICU patients who underwent a BG assay were retrospectively studied. The timing and dosage of albumin, use of azole treatment, and infusions of intravenous IgG, red blood cells, concentrated platelets, and frozen plasma were analyzed to find possible correlations with the BG results. The sensitivity and specificity of the BG assay were calculated. The BG test in serum showed high sensitivity (82.9%) but low specificity (56.7%). The optimal cut-off for the test was 95.9pg/mL. The mean BG level in proven invasive candidiasis was around 400pg/mL. The only factor that was found to significantly confound (p < 0.05) the diagnostic performance of the BG assay was the administration of more than 30g of albumin within 2days prior to BG testing. The BG assay remains a useful diagnostic test in ICU patients and the levels of BG are useful in evaluating the positive predictive value of this biomarker. The only confounding factor in our study was the use of albumin. Springer-Verlag Berlin Heidelberg, 2014 Lo Cascio G. Microbiology and Virology Unit, Department of Pathology and Diagnostics, Azienda Ospedaliera Universitaria Integrata, Verona, Italy aut Koncan R. Department of Pathology and Diagnostics, University of Verona, Verona, Italy aut Stringari G. Department of Anesthesiological Sciences and Specialistic Surgeries, University of Verona, Verona, Italy aut Russo A. Department of Anesthesiological Sciences and Specialistic Surgeries, University of Verona, Verona, Italy aut Azzini A. Infectious Diseases Unit, Department of Pathology and Diagnostics, University of Verona, Verona, Italy aut Ugolini A. Department of Anesthesiological Sciences and Specialistic Surgeries, University of Verona, Verona, Italy aut Ligozzi M. Department of Pathology and Diagnostics, University of Verona, Verona, Italy aut Polati E. Department of Anesthesiological Sciences and Specialistic Surgeries, University of Verona, Verona, Italy aut Cornaglia G. Department of Pathology and Diagnostics, University of Verona, Verona, Italy aut Concia E. Infectious Diseases Unit, Department of Pathology and Diagnostics, University of Verona, Verona, Italy aut Schweiger V. Department of Anesthesiological Sciences and Specialistic Surgeries, University of Verona, Verona, Italy aut European Journal of Clinical Microbiology & Infectious Diseases Springer Berlin Heidelberg 34/2(2015-02-01), 357-365 0934-9723 34:2<357 2015 34 10096 https://doi.org/10.1007/s10096-014-2239-z text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10096-014-2239-z text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Lo Cascio G. Microbiology and Virology Unit, Department of Pathology and Diagnostics, Azienda Ospedaliera Universitaria Integrata, Verona, Italy aut NATIONALLICENCE 700 1- Koncan R. Department of Pathology and Diagnostics, University of Verona, Verona, Italy aut NATIONALLICENCE 700 1- Stringari G. Department of Anesthesiological Sciences and Specialistic Surgeries, University of Verona, Verona, Italy aut NATIONALLICENCE 700 1- Russo A. Department of Anesthesiological Sciences and Specialistic Surgeries, University of Verona, Verona, Italy aut NATIONALLICENCE 700 1- Azzini A. Infectious Diseases Unit, Department of Pathology and Diagnostics, University of Verona, Verona, Italy aut NATIONALLICENCE 700 1- Ugolini A. Department of Anesthesiological Sciences and Specialistic Surgeries, University of Verona, Verona, Italy aut NATIONALLICENCE 700 1- Ligozzi M. Department of Pathology and Diagnostics, University of Verona, Verona, Italy aut NATIONALLICENCE 700 1- Polati E. Department of Anesthesiological Sciences and Specialistic Surgeries, University of Verona, Verona, Italy aut NATIONALLICENCE 700 1- Cornaglia G. Department of Pathology and Diagnostics, University of Verona, Verona, Italy aut NATIONALLICENCE 700 1- Concia E. Infectious Diseases Unit, Department of Pathology and Diagnostics, University of Verona, Verona, Italy aut NATIONALLICENCE 700 1- Schweiger V. Department of Anesthesiological Sciences and Specialistic Surgeries, University of Verona, Verona, Italy aut NATIONALLICENCE 773 0- European Journal of Clinical Microbiology & Infectious Diseases Springer Berlin Heidelberg 34/2(2015-02-01), 357-365 0934-9723 34:2<357 2015 34 10096