中国感染控制杂志2018，Vol.17Issue(1)：41-46,6.DOI:10.3969/j.issn.1671-9638.2018.01.009
G试验和GM试验联合痰真菌培养对ICU患者侵袭性真菌感染的早期诊断
G-test and GM-test combined with sputum fungal culture for the early diagnosis of invasive fungal infection in intensive care unit patients
摘要
Abstract
Objective To evaluate the detection value of serum (1,3)-β-D glucan (G-test) and galactomannan (GM-test) combined with sputum fungal culture in the early diagnosis of invasive fungal infection(IFI) in intensive care unit(ICU) patients.Methods Inpatients with high risk factors for IFI in the ICU of the Affiliated Hospital of Xuzhou Medical University between January 2015 and December 2016 were chosen,they were divided into 3 groups according to the diagnostic criteria of IFI:IFI group(including confirmed and clinically diagnosed cases),suspected IFI group,and non-IFI group.The results of serum G-test,GM-test,and sputum fungal culture in three groups of patients were analyzed,early diagnostic value in IFI with combined three tests was evaluated.Results A total of 264 ICU patients were investigated,IFI group,suspected IFI group,and non-IFI group were 56,43,and 165 cases respectively.Among 56 cases of confirmed IFI,46,39,and 34 were positive for G-test,GM-test,and fungal culture respectively.The sensitivity,specificity,positive predictive value,and negative predictive value of combined three detection were 98.2％,82.4％,65.5％,and 99.3％ respectively,positive likelihood ratio,negative likelihood ratio,and Youden index were 5.58,0.02,and 0.98 respectively.The sensitivity and negative predictive values of combined three detection were both higher than those of single G-test,GM-test,and sputum fungal culture (all P＜0.05);but specificity and positive predictive value of combined three detection were not significantly different from single G-test,GM-test,and sputum fungal culture(all P＞0.05).Conclusion The combination of G-test,GM-tests,and sputum fungal culture can improve the sensitivity of early diagnosis of IFI in ICU patients,and guide the clinicians in the early treatment of IFI.关键词
(1,3)-B-D葡聚糖/半乳甘露聚糖/痰培养/危重症患者/侵袭性真菌感染/联合检测Key words
(1,3)-β-D-glucan test/galactomannan test/sputum culture/critically ill patient/invasive fungal infection/combined detection分类
医药卫生引用本文复制引用
孟文晴,陆璇,潘正慧,徐猛,李程浩,赵文静..G试验和GM试验联合痰真菌培养对ICU患者侵袭性真菌感染的早期诊断[J].中国感染控制杂志,2018,17(1):41-46,6.基金项目
2009年度“六大人才高峰”D类资助项目(2009059) （2009059）
