Role of Beta-D-Glucan in the Diagnosis of Invasive Fungal Infections in Patients with Hematological Malignancies

Abstract

Abstract Background Invasive fungal infections (IFIs) are important causes of high morbidity and mortality rates among immunocompromised patients with special consideration on patients with hematological malignancies (HMs), Establishing the diagnosis of IFIs in immunocompromised patients is challenging due to nonspecific clinical presentations and the limited sensitivity of traditional culture-based methods. Rapid non-culture-based diagnostics such as 1,3- beta-D-glucan (BDG) assay have emerged as promising adjuncts to conventional diagnostic modalities, The aim of this work is to determine the diagnostic performance of beta-D-glucan (BDG) as an adjunct diagnostic strategy for invasive fungal infections (IFIs) in patients with hematological. malignancies (HMs). Methods Fifty-one patients were enrolled from hemato-oncology department - Ain Shams University Hospital during the period from May 2022 till April 2023, enrolled subjects were classified into healthy controls (n = 13), pathological controls (n = 13), and cases group (n = 25), patients were subjected for BDG test, CBC with differential count, highly sensitive-CRP, and Microbiological cultures and/or Histopathological examination. Results at cut off 187.21 pg/ ml the maximum efficacy of BDG test was achieved concerning the cases versus the total controls with sensitivity 84%, specificity 84.6%, NPV 84.6%, PPV 84% and efficacy 84.3%. conclusion Detection of BDG antigen can be a valuable diagnostic modality if used in the proper clinical setting (i.e., immunosuppressed, neutropenic patients and patients with HMs) by a provider knowledgeable of both the advantages and limitations of the test being tailored to each individual patient for best clinical judgement.