Diagnostic accuracy of (1→3)-β-D-glucan to predict Pneumocystis jirovecii pneumonia in non-HIV-infected patients

(1→3)-β-D-glucan group	N = 108 patients	(1→3)-β-D-glucan (pg/mL) ± SD
< 100 pg/mL	24	81.14 ± 3.41
100–200 pg/mL	11	124.4 ± 22.37
200–300 pg/mL	4	238,75 ± 16,55
300–400 pg/mL	7	336.75 ± 20.18
400–500 pg/mL	8	454.13 ± 31.3
> 500 pg/mL*	54	> 500 pg/mL

[i] * Mean could not be calculated since samples dilutions to measure real (1→3)-β-D-glucan concentrations were not performed.

Table 3

Average Ct values for each (1→3)-β-D-glucan range

(1→3)-β-D-glucan group	N = 108 patients	Mean Ct ± SD
Group 1 < 100 pg/mL	24	35.43 ± 3.51
Group 2 100–200 pg/mL	11	34.82 ± 3.65
Group 3 200–300 pg/mL	4	37.33 ± 2.36
Group 4 300–400 pg/mL	7	35.27 ± 2.75
Group 5 400–500 pg/mL	8	29.41 ± 6.25*
Group 6 > 500 pg/mL	54	28.90 ± 5.18*

[i] Ct = threshold cycle; SD = standard deviation

* Statistically significant difference seen when Ct from group 1 to 4 are compared to group 5 and 6 combined, P < 0.001. Odds ratio (OR) is the greatest to predict PCP if (1→3)-β-D-glucan > 400 pg/mL, OR 2.31 (95%CI 1.62-3.27), p < 0.001).

Table 4

(1→3)-β-D-glucan values for patients with microbiologically confirmed PCP and possible PCP

PCP	108 patients	(1→3)-β-D-glucan (pg/mL) ± SD	qPCR Ct ± SD
Possible PCP	66 (61%)	256.06 ± 183.48	35.01 ± 3.8
Microbiologically confirmed PCP (DIF and qPCR positive)	42 (39%)	467.5 ± 95.5	27.2 ± 4.6
Subgroup definite PCP (DIF positive and qPCR Ct < 30 and response to treatment)	26 (24%)	494.81 ± 17.73*
P value		< 0.001	< 0.001

[i] Ct = threshold cycle; DIF = direct immunofluorescence; PCP = pneumocystis pneumonia; qPCR = real time PCR; SD = standard deviation

* Area under the curve (AUC) to predict PCP (positive DIF and qPCR) with measurement of (1→3)-β-D-glucan: AUC = 0.817, 95% CI: 0.736–0.898, sensitivity = 83.3%, specificity = 64.6%, cut off 496.45 pg/mL, p < 0.001

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DOI: https://doi.org/10.2478/raon-2020-0028 | Journal eISSN: 1581-3207 | Journal ISSN: 1318-2099

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Language: English

Page range: 221 - 226

Submitted on: Dec 31, 2019

Accepted on: Apr 14, 2020

Published on: May 28, 2020

Published by: Association of Radiology and Oncology

In partnership with: Paradigm Publishing Services

Publication frequency: 4 issues per year

Keywords:

Pneumocystis jirovecii pneumonia,

(1→3)-β-D-glucan,

DIF,

real-time PCR,

colonization with P. jirovecii,

non-HIV-infected patients

Related subjects:

Medicine,

Clinical medicine,

Radiology

© 2020 Petra Rogina, Miha Skvarc, published by Association of Radiology and Oncology
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Volume 54 (2020): Issue 2 (June 2020)