THE ROLE OF ESTIMATION OF BETA –D-GLUCAN IN EARLY DIAGNOSIS OF FUNGEMIA IN FEBRILE NEUTROPENIC PATIENTS.

Abstract

Blood Stream infection (BSI) is the major causes of morbidity and mortality in leukemic patients with neutropenic fever. Early diagnosis of fungemia is a challenge to the clinician and the laboratory. There is a growing attention in the use of aβ-D-Glucan(βDG) biomarker for rapid detection of fungemia. To evaluate the diagnostic role of β-D-Glucan as early diagnostic markers of fungemia in febrile neutropenic patients (FN),β-DGlucan (βDG) levels were determined in 75 leukemic patients with neutropenic fever. They were measured in serum samples obtained from those patients at the same time when blood was drawn for blood culture.Out of the 75 patients with febrile neutropenia enrolled in this study, 10 patients had a positive blood culture (13.3%), eight of the isolates were bacteria (5 Gram negative and 3 Gram positive) and only two of the isolates were fungi.β-DGlucan(βDG) levels of >0.1020pg/ml were considered as positive, current study revealed that out of 75 patients,10(13.3%) patients had levels greater than 1020pg/ml, ROC analysis revealed maximum sensitivity of 81.3%,and a specificity of 66.7%. In conclusion β-D-Glucan showing acceptable sensitivity and can provide rapid detection for fungemia in FN patients, which can lead to avoid prolonged and empirical used of treatment.