Low cut-off value of serum (1,3)-beta-d-glucan for the diagnosis of Pneumocystis pneumonia in non-HIV patients: a retrospective cohort study

Abstract Background Non-human immunodeficiency virus (HIV) Pneumocystis pneumonia (PCP) is a fulminant disease with an increasing incidence. The serum beta-d-glucan (BDG) assay is used as an adjunct to the diagnosis of PCP; however, the cut-off value for this assay is not well-defined, especially in...

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Autores principales:	Jumpei Taniguchi, Kei Nakashima, Hiroki Matsui, Tomohisa Watari, Ayumu Otsuki, Hiroyuki Ito, Yoshihito Otsuka
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Cut-off value Diagnostic performance evaluation Non-HIV Pneumocystis pneumonia Retrospective cohort study Serum (1,3)-beta-d-glucan Infectious and parasitic diseases RC109-216
Acceso en línea:	https://doaj.org/article/176be6da68f9446dbf36aa892b1c1fa5
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spelling	oai:doaj.org-article:176be6da68f9446dbf36aa892b1c1fa52021-12-05T12:26:10ZLow cut-off value of serum (1,3)-beta-d-glucan for the diagnosis of Pneumocystis pneumonia in non-HIV patients: a retrospective cohort study10.1186/s12879-021-06895-x1471-2334https://doaj.org/article/176be6da68f9446dbf36aa892b1c1fa52021-11-01T00:00:00Zhttps://doi.org/10.1186/s12879-021-06895-xhttps://doaj.org/toc/1471-2334Abstract Background Non-human immunodeficiency virus (HIV) Pneumocystis pneumonia (PCP) is a fulminant disease with an increasing incidence. The serum beta-d-glucan (BDG) assay is used as an adjunct to the diagnosis of PCP; however, the cut-off value for this assay is not well-defined, especially in the non-HIV PCP population. Therefore, we aimed to identify the assay cut-off value for this population. Methods In this retrospective observational study, we reviewed the medical records of all patients (≥ 18 years old) with clinical suspicion of PCP who underwent evaluation of respiratory tract specimens between December 2008 and June 2014 at Kameda Medical Center. We created a receiver operating characteristic curve and calculated the area under the curve to determine the cut-off value for evaluating the inspection accuracy of the BDG assay. Results A total of 173 patients were included in the study. Fifty patients showed positive results in specimen staining, loop-mediated isothermal amplification assay, and polymerase chain reaction test, while 123 patients showed negative results. The receiver operating characteristic analyses suggested that the BDG cut-off level was 8.5 pg/mL, with a sensitivity and specificity of 76% and 76%, respectively. Conclusions The Wako-BDG cut-off value for the diagnosis of non-HIV PCP is 8.5 pg/mL, which is lower than the classical cut-off value from previous studies. Clinicians should potentially consider this lower BDG cut-off value in the diagnosis and management of patients with non-HIV PCP. Trial registration: The participants were retrospectively registered.Jumpei TaniguchiKei NakashimaHiroki MatsuiTomohisa WatariAyumu OtsukiHiroyuki ItoYoshihito OtsukaBMCarticleCut-off valueDiagnostic performance evaluationNon-HIV Pneumocystis pneumoniaRetrospective cohort studySerum (1,3)-beta-d-glucanInfectious and parasitic diseasesRC109-216ENBMC Infectious Diseases, Vol 21, Iss 1, Pp 1-7 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Cut-off value Diagnostic performance evaluation Non-HIV Pneumocystis pneumonia Retrospective cohort study Serum (1,3)-beta-d-glucan Infectious and parasitic diseases RC109-216
spellingShingle	Cut-off value Diagnostic performance evaluation Non-HIV Pneumocystis pneumonia Retrospective cohort study Serum (1,3)-beta-d-glucan Infectious and parasitic diseases RC109-216 Jumpei Taniguchi Kei Nakashima Hiroki Matsui Tomohisa Watari Ayumu Otsuki Hiroyuki Ito Yoshihito Otsuka Low cut-off value of serum (1,3)-beta-d-glucan for the diagnosis of Pneumocystis pneumonia in non-HIV patients: a retrospective cohort study
description	Abstract Background Non-human immunodeficiency virus (HIV) Pneumocystis pneumonia (PCP) is a fulminant disease with an increasing incidence. The serum beta-d-glucan (BDG) assay is used as an adjunct to the diagnosis of PCP; however, the cut-off value for this assay is not well-defined, especially in the non-HIV PCP population. Therefore, we aimed to identify the assay cut-off value for this population. Methods In this retrospective observational study, we reviewed the medical records of all patients (≥ 18 years old) with clinical suspicion of PCP who underwent evaluation of respiratory tract specimens between December 2008 and June 2014 at Kameda Medical Center. We created a receiver operating characteristic curve and calculated the area under the curve to determine the cut-off value for evaluating the inspection accuracy of the BDG assay. Results A total of 173 patients were included in the study. Fifty patients showed positive results in specimen staining, loop-mediated isothermal amplification assay, and polymerase chain reaction test, while 123 patients showed negative results. The receiver operating characteristic analyses suggested that the BDG cut-off level was 8.5 pg/mL, with a sensitivity and specificity of 76% and 76%, respectively. Conclusions The Wako-BDG cut-off value for the diagnosis of non-HIV PCP is 8.5 pg/mL, which is lower than the classical cut-off value from previous studies. Clinicians should potentially consider this lower BDG cut-off value in the diagnosis and management of patients with non-HIV PCP. Trial registration: The participants were retrospectively registered.
format	article
author	Jumpei Taniguchi Kei Nakashima Hiroki Matsui Tomohisa Watari Ayumu Otsuki Hiroyuki Ito Yoshihito Otsuka
author_facet	Jumpei Taniguchi Kei Nakashima Hiroki Matsui Tomohisa Watari Ayumu Otsuki Hiroyuki Ito Yoshihito Otsuka
author_sort	Jumpei Taniguchi
title	Low cut-off value of serum (1,3)-beta-d-glucan for the diagnosis of Pneumocystis pneumonia in non-HIV patients: a retrospective cohort study
title_short	Low cut-off value of serum (1,3)-beta-d-glucan for the diagnosis of Pneumocystis pneumonia in non-HIV patients: a retrospective cohort study
title_full	Low cut-off value of serum (1,3)-beta-d-glucan for the diagnosis of Pneumocystis pneumonia in non-HIV patients: a retrospective cohort study
title_fullStr	Low cut-off value of serum (1,3)-beta-d-glucan for the diagnosis of Pneumocystis pneumonia in non-HIV patients: a retrospective cohort study
title_full_unstemmed	Low cut-off value of serum (1,3)-beta-d-glucan for the diagnosis of Pneumocystis pneumonia in non-HIV patients: a retrospective cohort study
title_sort	low cut-off value of serum (1,3)-beta-d-glucan for the diagnosis of pneumocystis pneumonia in non-hiv patients: a retrospective cohort study
publisher	BMC
publishDate	2021
url	https://doaj.org/article/176be6da68f9446dbf36aa892b1c1fa5
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Low cut-off value of serum (1,3)-beta-d-glucan for the diagnosis of Pneumocystis pneumonia in non-HIV patients: a retrospective cohort study

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