Evaluation of plasma (1-->3)-beta-D-glucan measurement by the kinetic turbidimetric Limulus test, for the clinical diagnosis of mycotic infections

Eur J Clin Chem Clin Biochem. 1997 Jul;35(7):553-60.

Abstract

The present multicentre clinical study was conducted to assess the clinical utility of a new diagnostic method for deep mycosis in which (1-->3)-beta-D-glucan, a fungal cell wall component existing in plasma, was quantitatively measured by the kinetic turbidimetric Limulus test (WB003). Plasma (1-->3)-beta-D-glucan concentrations were 0.57 +/- 0.10 microgram/l in 92 healthy subjects and 0.62 +/- 0.32 microgram/l in 26 patients with non-mycotic diseases (disease control group). In comparison with these healthy subjects and patients with non-mycotic diseases, patients with mycosis had significantly higher plasma (1-->3)-beta-D-glucan concentrations: 19.63 +/- 73.28 micrograms/l in 12 patients with candidaemia, 11.28 +/- 21.42 micrograms/l in 7 patients with urinary Candida infection, 4.84 +/- 12.71 micrograms/l in 5 patients with pulmonary candidiasis, and 12.21 +/- 31.31 micrograms/l in 4 patients with invasive pulmonary aspergillosis. On the statistical analysis of these data, a cut-off value was set at 1.0 microgram/l. Using this cut-off value, 3 patients with pulmonary cryptococcosis and 4 patients (4/6) with pulmonary aspergilloma were all negative with low plasma (1-->3-beta-D-glucan levels. The test WB003 provided equivalent or higher efficiency of diagnosis of candidiasis and aspergillosis, in comparison with commercially available antigen detection kits, demonstrating its utility as a diagnostic reagent. It may also be useful in assessing therapeutic effectiveness when used periodically after treatment.

Publication types

  • Case Reports
  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Aspergillosis / blood
  • Aspergillosis / diagnosis
  • Candidiasis / blood
  • Candidiasis / diagnosis
  • Cryptococcosis / blood
  • Cryptococcosis / diagnosis
  • Diagnostic Errors
  • Evaluation Studies as Topic
  • Female
  • Fungemia / blood
  • Fungemia / diagnosis
  • Glucans / blood*
  • Humans
  • Kinetics
  • Limulus Test / methods*
  • Limulus Test / statistics & numerical data
  • Lung Diseases, Fungal / blood
  • Lung Diseases, Fungal / diagnosis
  • Male
  • Middle Aged
  • Mycoses / blood*
  • Mycoses / diagnosis*
  • Nephelometry and Turbidimetry / methods
  • Nephelometry and Turbidimetry / statistics & numerical data
  • Time Factors
  • Urinary Tract Infections / blood
  • Urinary Tract Infections / diagnosis
  • beta-Glucans*

Substances

  • Glucans
  • beta-Glucans
  • beta-1,3-glucan