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G test, GM test combined with inflammation indicators lead a new trend in the detection of fungi and bacteria

 Last Update: 2021-05-03
 Source: Internet
 Author: User

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At present, with the continuous upgrading of medical diagnosis technology, the thorny clinical treatment problem of infectious diseases is gradually being addressed.

Knowing this, what are the several test indicators mentioned in the literature? What is the clinical significance of biomarkers for differential diagnosis? Let us find out together!

65pt;text-indent:2em;"> Infectious diseases are often not specific due to their symptoms, signs and imaging manifestations, and some non-infectious diseases also have some clinical manifestations that resemble infections, and misdiagnosis is very easy to occur in the diagnosis of infectious diseases.

Clinical significance of infection-related biomarkers

G test and GM test are common clinical detection methods for fungi.

PCT, CRP and IL-6 are currently commonly used clinical indicators for systemic inflammatory response.

The G test is suitable for the detection of pan-fungal infections, and the GM test is the main clinical detection method for Aspergillus.

In clinical diagnosis, the combined detection of multiple indicators can effectively improve the sensitivity, specificity, negative and positive predictive values of fungal and bacterial infections and other important indicators.

In January 2020, Guo Jingjing et al.

The results of the study of various indicators are shown in the figure.

In January 2021, Miao Qiang et al.

The literature included 124 hospitalized patients with high-risk IFI factors, and compared the levels of PCT, CRP, IL-6, BDG and GM test indicators in patients with bacterial and fungal infections, and used receiver operating curve (ROC) to evaluate each indicator individually and in combination The value of testing for the diagnosis of fungal bloodstream infections.

The levels of serum PCT, CRP and IL-6 in the fungus group were significantly lower than those in the bacteria group, and the difference was statistically significant (all P <0.

7pt;text-indent:2em;"> The ROC curve of individual and combined detection of each index to identify fungal bloodstream infections shows that the area under the ROC curve of PCT, CRP, IL-6 and BDG are 0.
859, 0.
718, 0.
800 and 0.
843, which are useful for the auxiliary diagnosis of fungal bloodstream infections.
Certain value (P <0.
05).
It is worth noting that the combined AUC of the four indicators is higher than that of a single test, and the sensitivity, specificity, negative and positive predictive values are all improved, indicating that PCT and other inflammatory indicators combined with BDG testing can be used in the early differential diagnosis of fungal and bacterial bloodstream infections.
There is a certain clinical value [1].

In addition, Jiang Yuehong et al.
[6] pointed out that the percentage of (1,3)-β-D-glucan and CRP in plasma can reflect the presence of fungal infection, while the level of plasma (1,3)-β-D-glucan can reflect blood In severe cases of influenza infection, the PCT level can be preliminarily inferred whether it is a non-Candida albicans infection or a Candida albicans infection.

It should be pointed out that no biomarker is absolutely sensitive and absolutely specific, and the change of a certain biomarker cannot be used to diagnose the disease.
It can only be done by combining and referring to the clinical manifestation of the patient and the results of other laboratory tests.
Make the correct judgment [2].

* The combined detection of multiple indicators has broadened new ideas for the diagnosis of fungal and bacterial infections.
Fully automatic detection products help the diagnosis business to enter the fast lane.

The comprehensive fungus and bacteria detection program makes the experiment more accurate and efficient.
The IGL series of fungal and bacterial dynamic detectors innovatively realize (1, 3)-β-D glucan and gram-negative bacteria lipopolysaccharides are automatically detected.
FACIS automatic chemiluminescence enzyme immunoassay instrument has achieved the GM experiment.
Fully automatic detection, it is expected that a fully automatic intelligent detection platform covering multiple biological markers will be built, and the joint detection of multiple indicators will be perfectly realized, laying a solid foundation for the arrival of the intelligent era of fungus and bacteria detection.

references:

[1] Miao Qiang, Xu Xiaohua, Wei Bin, Bai Yangjuan, Zhang Junlong, Cai Bei, Niu Qian.
Detection of inflammatory indicators combined with (1,3)-β-D glucan in the early differential diagnosis of fungal and bacterial bloodstream infections The value of [J].
The Journal of Practical Medicine,2021,37(01):96-100.

[2] Liu Youning, Xie Lixin.
Expert consensus on interpretation of clinical significance of infection-related biomarkers [J].
Chinese Journal of Tuberculosis and Respiratory, 2017, 40(04): 243-257.

[3] Zhu Meiying, Cao Ehong.
Detection and application of procalcitonin-interpretation of "Expert consensus on interpretation of clinical significance of infection-related biomarkers" [J].
Shanghai Medicine, 2018, 39(01): 14-18.

[4] Guo Jingjing, Li Qinfeng, Wu Haihua, Ding Chen, Shi Fangyu.
The diagnostic value of (1,3)-β-D glucan, galactomannan combined with procalcitonin in the diagnosis of invasive fungal infections[J].
International Journal of Immunology, 2020(01): 31-32-33-34-35-36.

[5] MAERTENS J, THEUNISSEN K, VERBEKEN E, et al.
Pro-spective clinical evaluation of lower cut ⁃ offs for galactomannan detection in adult neutropenic cancer patients and haematologi-cal stem cell transplant recipients［J］.
Br J Haematol, 2004 , 126(6): 852-860.

[6] Jiang Yuehong, Li Xiaolin, Sun Jian, Yan Li, Wang Tong, You Yuhong, Jin Wei, Wang Feng, Zhang Chao.
Effects of plasma (1,3)-β-D glucan and C-reactive protein on fungal activity Evaluation of bloodstream infection[J].
Chinese Medical Science,2019,9(03):9-12.

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