Performance of serum (1,3)‐?‐ d d ‐glucan screening for the diagnosis of invasive aspergillosis in neutropenic patients with haematological malignancies

摘要

Summary We report our experience with the use of (1,3)‐?‐ d ‐glucan ( BDG ) screening for the diagnosis of invasive aspergillosis ( IA ) in neutropenic patients with haematological malignancies. The performance of BDG screening was assessed retrospectively in per patient and per sample analyses. Overall, 20 among 167 patients developed IA (12%). In the per patient analysis, BDG showed 60% sensitivity and 78% specificity when the criterion for positivity was the presence of at least one BDG value ≥80?pg/mL. For 2 consecutive positive results, sensitivity decreased to 40%, while specificity increased to 93% and was similar to that of a positive galactomannan ( GM ; 90%). The highest specificity (97%) was observed for combined positivity of at least one BDG and at least one GM . In the per sample analysis, the specificity of BDG was 100% in the best scenario, 96% in the median scenario and 89% in the worst scenario. BDG became positive before GM in 33% of IA patients with both markers positive (n?=?12). Despite good specificity for 2 consecutive positive results, the BDG test offered unsatisfactory performance for the diagnosis of IA due to low sensitivity. The combination of BDG and GM showed the potential for increasing specificity.