@article{Mirchevska_Cekovska_Kaftandzieva_Zafirovik_Trajkovska-Dokic_2022, title={Evaluation of (1,3)--d-glucan assay in diagnosis of invasive fungal infections with Aspergillus }, volume={14}, url={https://www.id-press.eu/aph/article/view/6045}, DOI={10.3889/aph.2022.6045}, abstractNote={<p>Invasive fungal infections caused by <em>Aspergillus </em>are a significant problem in immunocompromised and critically ill patients and associated with increased morbidity and mortality. Early diagnosis of invasive aspergillosis is still a big clinical and diagnostic challenge. Conventional methods are not sensitive enough, and therefore, there is a need for rapid, more sensitive methods for early diagnosis of invasive fungal infections with <em>Aspergillus</em>. The aim of this study was to evaluate the diagnostic performance, sensitivity and specificity of serological panfungal (1,3)-b-D-glucan marker compared to conventional method for diagnosis of invasive fungal infections with <em>Aspergillus</em>. Material and methods: Specimens of 125 patients divided into 4 groups (group I - immune deficiency, group II - prolonged ICU stay, group III - chronic aspergillosis, group IV - cystic fibrosis), classified according to clinical diagnosis and EORTC/MSG criteria, were analyzed at the Institute of Microbiology and Parasitology, with conventional and serological methods, during a period of two years. Results: A total of 71 isolates of <em>Aspergillus </em>were confirmed in this study. Four isolates were recovered from bloodculture of patients with primary immune deficiency. With BAL culture, <em>Aspergillus</em> was detected in the group of chronic aspergillosis (63.33%), followed by the groups of cystic fibrosis (56.67%), primary immune deficiency (51.43%), and the group with prolonged ICU stay (43.33%). Sensitivity and specificity of BAL culture were: 64.29% and 100%, 59.09% and 100%, 54.55% and 12.5%, 100% and 54.17%, in I, II, III and IV group, respectively. In 79.1% (53/67) from positive BAL cultures in all groups, <em>A. fumigatus </em>was confirmed, of which, 32.1% (17/53) in group III, followed by group I – 26.42% (14/53) and group IV – 26.42% (14/53), and 15.1% (8/53) in group II. Other species confirmed in BAL were <em>A. flavus </em>16.42% (11/67) and <em>A.terreus </em>4.48% (3/67). Sensitivity and specificity of the serological panfungal (1,3)-b-D-glucan (BDG) marker were: 64.71% and 85.71%, 50% and 87.5%, 36.36% and 50%, in groups I, II and III, respectively. No positive findings of the panfungal (1,3)-b-D-glucan (BDG) marker were found in the group with cystic fibrosis. Conclusion: The results obtained in this study have demonstrated that a positive (1,3)-b-D-glucan assay highlights the value of this test as a diagnostic adjunct in the serodiagnosis of invasive fungal infections with <em>Aspergillus</em>, and along with the results from conventional mycological investigation, helped in reaching a timely antifungal treatment with a favorable clinical outcome.</p> <p><strong> </strong></p>}, number={1}, journal={Archives of Public Health}, author={Mirchevska, Gordana and Cekovska, Zaklina and Kaftandzieva, Ana and Zafirovik, Zorica and Trajkovska-Dokic, Elena}, year={2022}, month={Jun.} }