Combined Use of Presepsin and (1,3)-β-D-glucan as Biomarkers for Diagnosing Candida Sepsis and Monitoring the Effectiveness of Treatment in Critically Ill Patients
Status PubMed-not-MEDLINE Jazyk angličtina Země Švýcarsko Médium electronic
Typ dokumentu časopisecké články
PubMed
35330311
PubMed Central
PMC8954802
DOI
10.3390/jof8030308
PII: jof8030308
Knihovny.cz E-zdroje
- Klíčová slova
- (1,3)-β-D-glucan, C-reactive protein, Candida, bloodstream infections, presepsin, procalcitonin, sepsis,
- Publikační typ
- časopisecké články MeSH
New biomarker panel was developed and validated on 165 critically ill adult patients to enable a more accurate invasive candidiasis (IC) diagnosis. Serum levels of the panfungal biomarker (1,3)-β-D-glucan (BDG) and the inflammatory biomarkers C-reactive protein, presepsin (PSEP), and procalcitonin (PCT) were correlated with culture-confirmed candidemia or bacteremia in 58 and 107 patients, respectively. The diagnostic utility was evaluated in sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). BDG was the best marker for IC, achieving 96.6% sensitivity, 97.2% specificity, 94.9% PPV, and 98.1% NPV at a cut-off of 200 pg/mL (p ≤ 0.001). PSEP exhibited 100% sensitivity and 100% NPV at a cut-off of 700 pg/mL but had a lower PPV (36.5%) and low specificity (5.6%). Combined use of PSEP and BDG, thus, seems to be the most powerful laboratory approach for diagnosing IC. Furthermore, PSEP was more accurate for 28-day mortality prediction the area under the receiver operating characteristic curve (AUC = 0.74) than PCT (AUC = 0.31; PCT cut-off = 0.5 ng/mL). Finally, serum PSEP levels decreased significantly after only 14 days of echinocandin therapy (p = 0.0012). The probability of IC is almost 100% in critically ill adults with serum BDG and PSEP concentrations > 200 pg/mL and >700 pg/mL, respectively, defining a borderline between non-invasive superficial Candida colonization and IC.
Center of Health Services Institute of Public Health in Ostrava 702 00 Ostrava Czech Republic
Department of Anesthesiology and Resuscitation Ostrava City Hospital 728 80 Ostrava Czech Republic
Department of Internal Medicine University Hospital Ostrava 708 00 Ostrava Czech Republic
Department of Internal Medicine University of Ostrava 703 00 Ostrava Czech Republic
Institute of Microbiology of the Czech Academy of Sciences 142 20 Prague Czech Republic
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