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β-D-Glucan Testing in Candidemia : Determinants of Positivity and Association With Mortality

Oldberg, Karl LU orcid ; Stenmark, Jakob and Hammarström, Helena (2025) In Mycoses 68(5).
Abstract

Background: Serum 1,3-β-d-glucan (BDG) tests are frequently used for diagnosing invasive candidiasis. However, BDG tests remain negative in many patients with candidemia, and factors influencing the probability for positive test results are poorly understood. Objectives: To study clinical and microbiological factors predictive of a positive BDG test, as well as the association of a positive BDG test with mortality in patients with candidemia. Methods: In a retrospective cohort of patients with candidemia, BDG was analysed by the Glucatell assay and the Wako Beta-Glucan Test. Predisposing conditions, focus of infection and other variables were retrieved from medical charts and laboratory databases. Their association with a positive BDG... (More)

Background: Serum 1,3-β-d-glucan (BDG) tests are frequently used for diagnosing invasive candidiasis. However, BDG tests remain negative in many patients with candidemia, and factors influencing the probability for positive test results are poorly understood. Objectives: To study clinical and microbiological factors predictive of a positive BDG test, as well as the association of a positive BDG test with mortality in patients with candidemia. Methods: In a retrospective cohort of patients with candidemia, BDG was analysed by the Glucatell assay and the Wako Beta-Glucan Test. Predisposing conditions, focus of infection and other variables were retrieved from medical charts and laboratory databases. Their association with a positive BDG test, and the association between positive BDG and death was tested in univariate analysis and multivariable logistic regression. Results: We included 134 patients with candidemia. Positive BDG and a non-abdominal deep-seated focus of infection (e.g., hematogenously disseminated infection and deep mediastinal/pleural candidiasis) were positively correlated in univariate and multivariable analyses [Wako adjusted odds ratio 9.11 (95% CI 1.66–172, p = 0.039), Glucatell adjOR 9.14 (95% CI 1.66–172, p = 0.039)]. Having a positive BDG test increased the risk for 90 days mortality after controlling for potential confounders, mainly age, septic shock, and ICU admission [Wako adjOR 4.73 (95% CI 1.71–14.7, p = 0.0043), Glucatell adjOR 3.59 (95% CI 1.33–10.6, p = 0.015)]. Conclusions: In patients with candidemia, a positive BDG test is more common in the presence of a concomitant non-abdominal deep-seated infection. Patients with a positive BDG test have a higher 90-day mortality.

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author
; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Mycoses
volume
68
issue
5
article number
e70067
publisher
Wiley-Blackwell
external identifiers
  • pmid:40353632
  • scopus:105005232982
ISSN
0933-7407
DOI
10.1111/myc.70067
language
English
LU publication?
yes
id
924d17bc-fbbd-4691-9bac-c6bc40ab82af
date added to LUP
2025-08-01 11:04:32
date last changed
2025-08-02 03:23:38
@article{924d17bc-fbbd-4691-9bac-c6bc40ab82af,
  abstract     = {{<p>Background: Serum 1,3-β-d-glucan (BDG) tests are frequently used for diagnosing invasive candidiasis. However, BDG tests remain negative in many patients with candidemia, and factors influencing the probability for positive test results are poorly understood. Objectives: To study clinical and microbiological factors predictive of a positive BDG test, as well as the association of a positive BDG test with mortality in patients with candidemia. Methods: In a retrospective cohort of patients with candidemia, BDG was analysed by the Glucatell assay and the Wako Beta-Glucan Test. Predisposing conditions, focus of infection and other variables were retrieved from medical charts and laboratory databases. Their association with a positive BDG test, and the association between positive BDG and death was tested in univariate analysis and multivariable logistic regression. Results: We included 134 patients with candidemia. Positive BDG and a non-abdominal deep-seated focus of infection (e.g., hematogenously disseminated infection and deep mediastinal/pleural candidiasis) were positively correlated in univariate and multivariable analyses [Wako adjusted odds ratio 9.11 (95% CI 1.66–172, p = 0.039), Glucatell adjOR 9.14 (95% CI 1.66–172, p = 0.039)]. Having a positive BDG test increased the risk for 90 days mortality after controlling for potential confounders, mainly age, septic shock, and ICU admission [Wako adjOR 4.73 (95% CI 1.71–14.7, p = 0.0043), Glucatell adjOR 3.59 (95% CI 1.33–10.6, p = 0.015)]. Conclusions: In patients with candidemia, a positive BDG test is more common in the presence of a concomitant non-abdominal deep-seated infection. Patients with a positive BDG test have a higher 90-day mortality.</p>}},
  author       = {{Oldberg, Karl and Stenmark, Jakob and Hammarström, Helena}},
  issn         = {{0933-7407}},
  language     = {{eng}},
  number       = {{5}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Mycoses}},
  title        = {{β-D-Glucan Testing in Candidemia : Determinants of Positivity and Association With Mortality}},
  url          = {{http://dx.doi.org/10.1111/myc.70067}},
  doi          = {{10.1111/myc.70067}},
  volume       = {{68}},
  year         = {{2025}},
}