The Significance Of Continuous Measurement Of (1,3)-β-D Glucan For Diagnosis And Treatment Of Invasive Pulmonary Fungal Infection

Objective: To evaluate the significance of (1,3)-β-D glucan detectionfor diagnosis of invasive pulmonary fungal infection；2、To explore thesignificance of (1,3)-β-D glucan in the treatment efficacy evaluation ofinvasive pulmonary fungal infection by continuous measurement of (1,3)-β-Dglucan.Methods: Eighty-four patients who have the factor of invasivepulmonary fungal infection from April 2011 to December 2011 in SichuanAcademy of Medical Sciences .Sichuan Provincial People’s Hospital.Thepatients who were diagnosised with proven and probable invasive pulmonaryfungal infection divided into group A. The patients who were not diagnosisedwith invasive pulmonary fungal infection divided into group B. Plasma frompatients were detested the content of (1,3)-β-D glucan. The patients weretreated with intravenous and oral sequential antifungal drugs. Theconcentration of (1,3)-β-D glucan in plasma was detected in one week andtwo weeks after anti-pulmonary fungal treatment. We observed fungalinfection-related respiratory symptoms、chest signs、sputum microbial andchest imaging.Results: 24 of 37 IPFI patients were (1,3)-β-D glucan positive in groupA. The average value of (1,3)-β-D glucan positive was 150.11pg/ml;9 of 47patients were (1,3)-β-D glucan positive in group B. The average value of (1,3)-β-D glucan positive was 89.25pg/ml. Considering the clinical,Thesensitivity and specificity of single (1,3)-β-D glucan positive were 64.86%and 80.85%.The difference of concentration of (1,3)-β-Dglucan in plasmabetween group A and group B have statistically significant (P <0.05). Theaverage rank was 55.22 in group A. The average rank was 32.49 in group B.24 of 37 patients in group A were continuously observed in the process ofanti-fungal treatment.The amount of effective treatment and ineffectivetreatment were 18 and 6. The difference of concentration of (1,3)-β-Dglucanin plasma Before treatment and 1 week after treatment have statisticallysignificant (P <0.05). The average rank was 23.39 before treatment. Theaverage rank was 13.61 in 1 week after treatment. The difference ofconcentration of (1,3)-β-D glucan in plasma before treatment and 2 week aftertreatment have statistically significant (P <0.05). The average rank was 24.53before treatment. The average rank was 12.47 in 2 week after treatment.Thedifference of concentration of (1,3)-β-D glucan in plasma 1 week aftertreatment and 2 week after treatment have not statistically significant(P >0.05). The average rank was 19.67 in 1 week after treatment. The averagerank was 17.33 in 2 week after treatment.Conclusion: Plasma (1,3)-β-D glucan can be used as a basis fordiagnosis of invasive pulmonary fungal infection. Continuous measurementof (1,3)-β-D glucan can be used as a reference of the evaluation of theefficacy of antifungal therapy.