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Bigot, Jeanne; Leroy, Jordan; Chouaki, Taieb; Cholley, Laurence; Bigé, Naïke; Tabone, Marie-Dominique; Brissot, Eolia; Thorez, Sophie; Maizel, Julien; Dupont, Hervé; Sendid, Boualem; Hennequin, Christophe; Guitard, Juliette

ß-D-Glucan Assay in the Cerebrospinal Fluid for the Diagnosis of Non-cryptococcal Fungal Infection of the Central Nervous System: A Retrospective Multicentric Analysis and a Comprehensive Review of the Literature

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  • Media type: E-Article
  • Title: ß-D-Glucan Assay in the Cerebrospinal Fluid for the Diagnosis of Non-cryptococcal Fungal Infection of the Central Nervous System: A Retrospective Multicentric Analysis and a Comprehensive Review of the Literature
  • Contributor: Bigot, Jeanne; Leroy, Jordan; Chouaki, Taieb; Cholley, Laurence; Bigé, Naïke; Tabone, Marie-Dominique; Brissot, Eolia; Thorez, Sophie; Maizel, Julien; Dupont, Hervé; Sendid, Boualem; Hennequin, Christophe; Guitard, Juliette
  • Published: Oxford University Press (OUP), 2023
  • Published in: Clinical Infectious Diseases, 77 (2023) 5, Seite 711-720
  • Language: English
  • DOI: 10.1093/cid/ciad274
  • ISSN: 1058-4838; 1537-6591
  • Keywords: Infectious Diseases ; Microbiology (medical)
  • Origination:
  • Footnote:
  • Description: Abstract Background Except for cryptococcosis, fungal infection of the central nervous system (FI-CNS) is a rare but severe complication. Clinical and radiological signs are non-specific, and the value of conventional mycological diagnosis is very low. This study aimed to assess the value of β1,3-D-glucan (BDG) detection in the cerebrospinal fluid (CSF) of non-neonatal non-cryptococcosis patients. Methods Cases associated with BDG assay in the CSF performed in 3 French University Hospitals over 5 years were included. Clinical, radiological, and mycological results were used to classify the episodes as proven/highly probable, probable, excluded, and unclassified FI-CNS. Sensitivity and specificity were compared to that calculated from an exhaustive review of the literature. Results In total, 228 episodes consisting of 4, 7, 177, and 40 proven/highly probable, probable, excluded, and unclassified FI-CNS, respectively, were analysed. The sensitivity of BDG assay in CSF to diagnose proven/highly probable/probable FI-CNS ranged from 72.7% [95% confidence interval {CI}: 43.4%‒90.2%] to 100% [95% CI: 51%‒100%] in our study and was 82% in the literature. For the first time, specificity could be calculated over a large panel of pertinent controls and was found at 81.8% [95% CI: 75.3%‒86.8%]. Bacterial neurologic infections were associated with several false positive results Conclusions Despite its sub-optimal performance, BDG assay in the CSF should be added to the diagnostic armamentarium for FI-CNS.