Held, J. and Koch, M. S. and Reischl, U. and Danner, T. and Serr, A. (2011) Serum (1 -> 3)-beta-D-glucan measurement as an early indicator of Pneumocystis jirovecii pneumonia and evaluation of its prognostic value. CLINICAL MICROBIOLOGY AND INFECTION, 17 (4). pp. 595-602. ISSN 1198-743X, 1469-0691
Full text not available from this repository. (Request a copy)Abstract
P>Pneumocystis jirovecii (carinii) pneumonia (PJP) is a major cause of disease in immunocompromised individuals. However, until recently no reliable and specific serological parameters for the diagnosis of PJP have been available. (1 -> 3)-beta-d-Glucan (BG) is a cell wall component of P. jirovecii and of various other fungi. Data from the past few years have pointed to serum measurement of BG as a promising new tool for the diagnosis of PJP. We therefore conducted a retrospective study on 50 patients with PJP and 50 immunocompromised control patients to evaluate the diagnostic performance of serum BG measurement. Our results show an excellent diagnostic performance with a sensitivity of 98.0% and a specificity of 94%. While the positive predictive value was only 64.7%, the negative predictive value was 99.8% and therefore a negative BG result almost rules out PJP. BG levels were already strongly elevated in an average of 5 days and up to 21 days before microbiological diagnosis demonstrating that the diagnosis could have been confirmed earlier. BG levels at diagnosis and maximum BG levels during follow-up did not correlate with the outcome of patients or with the P. jirovecii burden in the lung as detected by Real-Time PCR. Therefore, absolute BG levels seem to be of no prognostic value. Altogether, BG is a reliable parameter for the diagnosis of PJP and could be used as a preliminary test for patients at risk before a bronchoalveolar lavage is performed.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | BETA-D-GLUCAN; CARINII-PNEUMONIA; MEMBRANE FILTERS; DIAGNOSIS; ASSAY; PLASMA; MARKER; BLOOD; (1->3)-BETA-D-GLUCAN; COLONIZATION; beta-d-Glucan; Pneumocystis jirovecii pneumonia; prognosis |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Medizinische Mikrobiologie und Hygiene |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 23 Jun 2020 06:36 |
| Last Modified: | 23 Jun 2020 06:36 |
| URI: | https://pred.uni-regensburg.de/id/eprint/21046 |
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