Abstract:

Objective To investigate the roles of galactomannan （GM） test and（1,3）-beta-D-glucan （G）test for patients with invasive pulmonary fungal infection （IPFI）. Methods The antigen levels of GM and G were determined by GM test and G test,respectively. The sensitivities,specificities,positive predictive values,negative predictive values,accuracies and missed diagnosis rates of GM test and G test were calculated. The information of IPFI patients,including age,department,concurrent disease,fungus species,correlation infection index and drug treatment efficiency,were analyzed retrospectively. Results There were 435 positive cases,and the proportions of males and females accounted for 63.0% and 37.0%,respectively. The age was （55.3±26.6）years old,and the patients over 50 years old accounted for 64.1%. The departments of respiratory,pediatrics and intensive care unit （ICU） accounted for 30.6%,17.5% and 14.2%,respectively. The proportions of severe pneumonia and chronic obstructive pulmonary disease （COPD） patients accounted for 31.5%. There were 88 isolates of Aspergillus fumigatus,36 isolates of Calbicans,12 isolates of Candida tropicalis and 6 isolates of Candida glabrata. The increase rates of C-reactive protein （CRP）,procalcitonin （PCT） and D-dimer （DD） were 77.0%,91.6% and 82.9%,respectively. The sensitivity,specificity,positive predictive value,negative predictive value,accuracy and missed diagnosis rate of GM test were 86.3%,93.0%,91.4%,88.7%,89.9% and 13.7%,and those of G test were 78.3%,77.2%,80.4%,74.9%,77.8% and 21.7%,respectively. The positive rates of GM test and G test were 34.7% and 42.3%（P>0.05）. The effective rates of voriconazole and caspofungin were 81.4% and 58.8%.Conclusions GM test and G test play roles in the clinical diagnosis of IPFI. The risk factors of IPFI include children,elderly male patients over 50 years old,severe pneumonia,COPD,blood diseases, rheumatic autoimmune disease,cerebral hemorrhage,cerebral infarction,uremia,tumor,Aspergillus fumigatus infection and Calbicans infection. Voriconazole and caspofungin are good treatment options.

Key words: Galactomannan, （1,3）-beta-D-glucan, Invasive pulmonary fungal infection, Voriconazole, Caspofungin