血浆1-3-β-D葡聚糖检测深部真菌感染的应用研究

Application of Detection of Plasma 1-3-β-D Glucan in Invasive Fungal Infection

目的探讨血浆1-3-β-D葡聚糖水平检测与传统真菌培养方法的一致性,为深部真菌感染的临床诊断寻找快速、准确的方法。方法对212例临床疑似深部真菌感染病例采集静脉血标本,用MB-80微生物动态快速检测系统测定血浆1-3-β-D葡聚糖,同时行痰液真菌培养和真菌涂片染色,比较血浆1-3-β-D葡聚糖水平检测与传统真菌培养方法的一致性。结果本组88例血浆1-3-β-D葡聚糖阳性,24例可疑阳性,阳性率52.8%。84例痰液真菌培养阳性,阳性率39.6%,其中78例(92.9%%)1-3-β-D葡聚糖阳性。46例真菌涂片染色阳性,阳性率21.7%,其中42例1-3-β-D葡聚糖阳性。若以真菌培养结果作为诊断标准,则1-3-β-D葡聚糖检测的灵敏度为95.3%,特异性为90.6%。结论血浆1-3-β-D葡聚糖水平检测比痰液真菌培养能更早、更灵敏地反映深部真菌感染,但具有一定的假阴性率,故应同时行真菌培养,以提高诊断准确性。

Objective To explore the consistency between the level detection of 1-3-β-D glucan in plasma and the conventional assays of fungal culture and to develop a rapid and accurate method to diagnose invasive fungal infection. Methods Venous blood was collected from 212 patients who were suspected of having invasive fungal infection. Then the plasma 1- 3-β-D glucan from those patients were detected by the MB-80 microbial dynamic fast detection system. Meanwhile sputum was cultured and fungat smears were detected, and the consistency of the level detection of 1-3-β-D glucan in plasma and the con- ventional assays of fungal culture was compared. Results 88 patients were 1-3-β-D glucan-positive, 24 were suspicious of be- ing 1-3-β-D glucan-positive, and the positivity rate was 52.8%. 84 patients （39.6%） were fungal culture-positive, among whom,78 （92.9%）were 1-3-β-D glucan-positive. 46 samples（21.7% ）were identified by the fungal smears, among whom, 42 were 1-3-β-D glucan-positive. If the results of fungal cuhure were considered to be the diagnostic criteria ,then the sensitivity rate of the plasma 1-3-β-D glucan detection was 95.3% ,and the specificity rate was 90.6%. Conclusion More convenient, sensitive and faster than fungal cuhure, the detection of plasma 1-3-β-D glucan can be used in the diagnosis of invasive fungal infection. But with some false-negative rate, fungal culture should also be carried out to improve the accuracy of the diagnosis at the same time.