- Beta-D-glucan has a low positive predictive value for diagnosis of invasive fungal infection in hematology patients prescribed antifungal prophylaxis.
Why this matters
- Patients treated with induction chemotherapy or stem cell transplant for hematologic malignancies require antifungal prophylaxis.
- Beta-D-glucan (BDG) is a common method of surveillance for diagnosis of suspected invasive fungal infections.
- Retrospective chart review of all BDG results in hematology patients receiving posaconazole or micafungin prophylaxis.
- BDG results were categorized at true-positive, true-negative, false-positive, or false-negative.
- Indications for diagnostic screening:
- Neutropenic fever >5 days in setting of broad-spectrum antibacterial agents.
- Clinical symptoms and diagnostic imaging suggesting fungal infection.
- Most patients had received either a stem cell transplant (49.7%) or induction chemotherapy (43.8%).
- The rate of true-positive BDG confirmation of infection was low.
- The negative predictive value of BDG was 95.7%.
- The sensitivity was 42.9% and the specificity was 88.1%.
- BDG was useful in excluding fungal infection, but not effective for infection diagnosis.
- Single-center, retrospective chart review.
- Results presented at a conference and not peer-reviewed.