Clinical profile and role of (1→3)-β-D-glucan level in probable sepsis patients for candidemia: A diagnostic test study

Q2 Medicine

Medical Journal Armed Forces India Pub Date : 2026-07-01 Epub Date: 2026-06-15 DOI:10.1016/j.mjafi.2026.04.007

Arun Kumar Yadav, Anuj Singhal, K. Kiran Kumar, Amul Kapoor, Renu Bala Yadav, Ashish Bahal, Gurpreet Singh, Naveen Chawla

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引用次数: 0

Abstract

Background

This study aimed to estimate the prevalence of candidemia, describe its clinical and risk factor profile, evaluate the diagnostic performance of serum (1→3)-β-D-glucan (BDG) compared with blood culture, and assess outcomes among probable sepsis patients with candidemia.

Methods

A cross-sectional diagnostic study was conducted at a tertiary care referral hospital in North India between October 2022 and January 2024. Consecutive probable sepsis patients in whom empirical antifungal therapy was considered were enrolled. Data were collected using a structured questionnaire, serum BDG estimation (Fungitell® assay), and blood cultures using the BacT/Alert® system. Statistical analysis was performed using R version 4.2.3 and IBM SPSS Statistics v20.0.

Results

Sixty-three patients were included, with a mean age of 56 ± 20 years; 73.0% were male. Culture-positive candidemia was detected in 31 patients (49%). Mean BDG levels were significantly higher in culture-positive cases compared with culture-negative cases (150.10 ± 32 vs. 68.62 ± 6.5 pg/mL), with an odds ratio (OR) of 4.59 (95% confidence interval [CI]: 1.40–14.96). The BDG assay demonstrated a sensitivity of 84% and specificity of 47%, with positive and negative likelihood ratios of 1.58 and 0.34, respectively. Diagnostic accuracy was 65%, and the number needed to diagnose was 3.25. Fever was a significant clinical risk factor, with an adjusted prevalence OR of 15.7 (P = 0.023).

Conclusion

The BDG assay demonstrates high sensitivity for candidemia but limited specificity, requiring cautious interpretation. It is best used as an adjunctive screening and decision-support tool to guide early empirical antifungal therapy in high-risk intensive care patients.

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（1→3）-β- d -葡聚糖水平在念珠菌可能脓毒症患者中的临床特征和作用：一项诊断试验研究

本研究旨在评估念珠菌病的患病率，描述其临床和危险因素，评估血清（1→3）-β- d -葡聚糖（BDG）与血培养的诊断效果，并评估可能脓毒症合并念珠菌病患者的预后。方法于2022年10月至2024年1月在印度北部的一家三级转诊医院进行了一项横断面诊断研究。考虑经验性抗真菌治疗的连续疑似脓毒症患者被纳入研究。数据收集采用结构化问卷，血清BDG估计（Fungitell®测定），并使用BacT/Alert®系统进行血培养。采用R 4.2.3版本和IBM SPSS Statistics v20.0进行统计学分析。结果共纳入63例患者，平均年龄56±20岁；73.0%为男性。31例（49%）患者检出培养阳性念珠菌。培养阳性患者的平均BDG水平显著高于培养阴性患者（150.10±32 vs. 68.62±6.5 pg/mL），优势比（OR）为4.59（95%可信区间[CI]: 1.40-14.96）。BDG检测灵敏度为84%，特异性为47%，阳性似然比为1.58，阴性似然比为0.34。诊断正确率为65%，需要诊断的人数为3.25人。发热是显著的临床危险因素，调整后患病率OR为15.7 （P = 0.023）。结论BDG检测念珠菌敏感性高，但特异性有限，需谨慎解释。最好作为辅助筛查和决策支持工具，指导高危重症患者早期经验性抗真菌治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Medical Journal Armed Forces India Medicine-Medicine (all)

CiteScore

3.40

自引率

0.00%

发文量

206

期刊介绍： This journal was conceived in 1945 as the Journal of Indian Army Medical Corps. Col DR Thapar was the first Editor who published it on behalf of Lt. Gen Gordon Wilson, the then Director of Medical Services in India. Over the years the journal has achieved various milestones. Presently it is published in Vancouver style, printed on offset, and has a distribution exceeding 5000 per issue. It is published in January, April, July and October each year.