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The following is a summary of “Prognostic value of serial (1,3)-β-D-glucan measurements in ICU patients with invasive candidiasis,” published in the July 2024 issue of Critical Care by Carelli et al.
Researchers conducted a retrospective study evaluating a decrease in serum (1,3)-β-D-glucan (BDG) correlates with lower mortality and assessing BDG downslope’s effectiveness in predicting clinical outcomes in invasive candidiasis.
They focused on patients with confirmed invasive Candidiasis with at least two BDG measurements in Italy over ten years (2012–2022).
The result showed 103 patients with a median age 47 [35–62] years, SAPS II score 67 [52–77]), bloodstream infections in 68 patients, and 35 had intra-abdominal infections. Serial BDG measurements revealed a decrease over time in 54 patients (BDG downslope group), while 49 patients showed no such decrease (N-BDG downslope group). Candida albicans was the most frequently isolated pathogen (61%), followed by C. parapsilosis (17%) and C. glabrata (12%), with no significant differences between the groups. Mortality related to invasive candidiasis was significantly lower in the BDG downslope group compared to the N-BDG downslope group (17% vs. 53%, P<0.01). Multivariate Cox regression analysis identified septic shock at the time of infection and CLD as factors associated with higher mortality (HR [95% CI]: 3.24 [1.25–8.44], P=0.02 and 7.27 [2.33–22.66], P< 0.01, respectively). A BDG downslope was the sole predictor of survival (HR [95% CI]: 0.19 [0.09–0.43], P<0.01). The area under the receiver operating characteristic curve for BDG downslope as a predictor of favorable clinical outcome was 0.74 (P=0.02), with a BDG downslope >70% predicting survival with 100% specificity and positive predictive value.
Investigators concluded that a decline in serum BDG was linked to lower mortality, with a sharp downslope predicting survival with high specificity in invasive candidiasis.
Source: ccforum.biomedcentral.com/articles/10.1186/s13054-024-05022-x
