Serum (1 → 3) β-D-glucan assay for discrimination between Pneumocystis jirovecii pneumonia and colonization

Sadatomo Tasaka, Seiki Kobayashi, Kazuma Yagi, Takahiro Asami, Ho Namkoong, Wakako Yamasawa, Makoto Ishii, Naoki Hasegawa, Tomoko Betsuyaku

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Polymerase chain reaction (PCR) technique is being increasingly used for the microbiological diagnosis of Pneumocystis pneumonia (PCP). As PCR is highly sensitive, it can be positive even in a patient with Pneumocystis colonization. In this study, we evaluated whether the β-d-glucan assay could be used to differentiate between PCP and Pneumocystis jirovecii colonization in immunocompromised patients with pulmonary infiltrates. We retrospectively evaluated data from 166 consecutive patients who underwent bronchoalveolar lavage for the diagnosis of PCP. Serum levels of β-d-glucan in the negative, colonization, probable PCP, and definite PCP groups were 20.2 ± 6.3, 48.8 ± 15.9, 89.9 ± 20.2, 224.9 ± 25.9 pg/mL, respectively. The β-d-glucan levels in the definite PCP group were significantly higher than those in the other 3 groups (p < 0.001). Serum β-d-glucan levels in patients with either definite or probable PCP (173.1 ± 18.8 pg/mL) were significantly greater than those in patients with colonization who had positive PCR results but improved without anti-PCP treatment (p < 0.002). The cut-off level for discrimination was estimated to be 33.5 pg/mL, with which the positive predictive value was 0.925. These results indicate that β-d-glucan is a useful marker to differentiate between PCP and Pneumocystis colonization. A positive β-D-glucan assay result might be a good indication to begin anti-PCP treatment.

Original languageEnglish
Pages (from-to)678-681
Number of pages4
JournalJournal of Infection and Chemotherapy
Volume20
Issue number11
DOIs
Publication statusPublished - 2014 Nov 1

Keywords

  • Bronchoalveolar lavage (1 → 3)-β-D-glucan
  • Colonization
  • Pneumocystis pneumonia
  • Polymerase chain reaction

ASJC Scopus subject areas

  • Microbiology (medical)
  • Pharmacology (medical)
  • Infectious Diseases

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