Serum β-d-glucan of critically ill patients with suspected ventilator-associated pneumonia: preliminary observations

J Crit Care. 2011 Oct;26(5):536.e1-536.e9. doi: 10.1016/j.jcrc.2011.01.002. Epub 2011 Mar 3.


Background: The purpose of this pilot study was to determine whether β-d-glucan (BG) was associated with Candida in the lung and risk of death in patients with suspected ventilator-associated pneumonia (VAP).

Methods: In a single-center observational study, we enrolled eligible adults within 24 hours of intensive care unit admission. Patients who developed suspected VAP were divided into 3 groups according to culture results. Serum BG levels and clinical outcomes were collected.

Results: Fifty-seven patients were included; 26 had no growth, 19 patients grew pathogenic bacteria only, and 12 patients grew only Candida. The proportion of patients with a positive BG tended to be greater in the Candida group (66.7% vs 26.3% in bacteria group vs 50.0% in culture-negative group, P = .09). The BG-positive patients were much more likely to die by day 28 than the BG-negative patients (odds ratio, 4.2; 95% confidence limits, 1.1-15.7; P = .03). Patients with both BG positivity and Candida in their lung secretions were much more likely to die compared with patients who did not.

Conclusions: β-d-Glucan positivity in patients with a suspected VAP may be a marker for Candida in the lung and worse outcomes. Further validation of this postulate is warranted.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Biomarkers / blood
  • Candida / isolation & purification*
  • Candidiasis / diagnosis*
  • Candidiasis / mortality
  • Critical Illness
  • Female
  • Hospital Mortality
  • Humans
  • Intensive Care Units / statistics & numerical data
  • Lung / microbiology*
  • Male
  • Middle Aged
  • Ontario / epidemiology
  • Pilot Projects
  • Pneumonia, Ventilator-Associated / blood*
  • Pneumonia, Ventilator-Associated / mortality
  • Prognosis
  • Prospective Studies
  • Risk Factors
  • beta-Glucans / blood*


  • Biomarkers
  • beta-Glucans