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VOLUME 22 , ISSUE 5 ( 2018 ) > List of Articles

BRIEF COMMUNICATION

Experience with β-D-Glucan assay in the management of critically ill patients with high risk of invasive candidiasis: An observational study

R. Madhumitha, V. Ramasubramanian, P. Nambi, D. Kumar, M.A. Thirunarayan

Keywords : Antifungal stewardship, invasive candidiasis, β-D-glucan

Citation Information : Madhumitha R, Ramasubramanian V, Nambi P, Kumar D, Thirunarayan M. Experience with β-D-Glucan assay in the management of critically ill patients with high risk of invasive candidiasis: An observational study. Indian J Crit Care Med 2018; 22 (5):364-368.

DOI: 10.4103/ijccm.IJCCM_4_18

License: CC BY-ND 3.0

Published Online: 01-05-2018

Copyright Statement:  Copyright © 2018; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Background: The (1,3)-β-D-glucan assay (BDG) is recommended for the early diagnosis of invasive candidiasis (IC). Methods: Records of 154 critically ill adults with suspected IC, on whom BDG was done, were analyzed. Patients were divided into three groups: Group A (confirmed IC), Group B (alternative diagnosis or cause of severe sepsis), and Group C (high candidal score and positive BDG [>80 pg/mL] but without a confirmed diagnosis of IC). Results: Mean BDG levels were significantly higher in Group A (n = 32) as compared to Group B (n = 60) and Group C (n = 62) (448.75 ± 88.30 vs. 144.46 ± 82.49 vs. 292.90 ± 137.0 pg/mL; P < 0.001). Discontinuation of empiric antifungal therapy based on a value <80 resulted in cost savings of 14,000 INR per day per patient. Conclusion: A BDG value of <80 pg/ml facilitates early discontinuation of empirical antifungal therapy, with considerable cost savings.


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