检测(1,3)-β-D葡聚糖对早产儿侵袭性真菌感染的诊断

Value of detection of (1,3)-β-D glucan in diagnosis of invasive fungal infection in premature infants

目的采用D试验检测(1,3)-β-D葡聚糖含量,探讨对早产儿侵袭性真菌感染的诊断价值。方法选择2012年1月至2014年12月在南方医科大学附属小榄医院NICU住院的早产儿以D试验检测(1,3)-β-D葡聚糖,同时进行血真菌培养,分析其含量水平及阳性率,并评价其诊断价值。结果 260例同时作血培养和(1,3)-β-D葡聚糖检测,送检率10.29%(260/2 525)。(1,3)-β-D葡聚糖阳性率12.31%(32/260),显著高于血培养阳性率的3.84%(10/260),差异有统计学意义(P<0.05);早产儿发现感染时(1,3)-β-D葡聚糖水平(258.0±210.0)pg/m L显著高于治疗1周后水平(37.5±17.15)pg/m L,差异有统计学意义(P<0.01)。结论检测血(1,3)-β-D葡聚糖,可作为有真菌感染危险因素早产儿的筛查项目,对早产儿侵袭性真菌感染具有早期诊断价值。

Objective To evaluate the value of detection of（1,3）-β-D glucan（G test）in diagnosis of invasive fungalinfection（IFI）in premature infants. Methods The premature infants at risk of IFI in Xiaolan Hospital of Southern MedicalUniversity were enrolled from January 2012 to December 2014.The concentration of（1,3）一 3-D—glucan were detected byGKT- 5MSet microbial dynamic detection system,and the blood samples were cultured for fungus. Then the results wereanalyzed. Resuits Blood samples from 260 neonates were both cultured and detected for the level of（1,3）-β-D glucan withinspection rate of 10.29%（260/2 525）and the incidence rate of invasive fungal infection in 1.27%（32/2 525）.The positiverate of（1,3）-β-D glucan was statistically and significantly higher than that of blood culture[12.31%（32/260）vs. 3.84%（10/260）,P〈0.05].The level of（1,3）-β-D glucan in premature infants was statistically significantly higher than that a week aftertreatment [（258.0±210.0）pg/ml vs.（37.5±17.15）pg/ml,P〈0.01]. Condusions（1,3）-β-D glucan assay（G test）can beused for the screening patients at high risk forinvasive fungal infection and it is valuable for early diagnosis of IFI in prematureinfants.