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Abstract: TH-PO396

Serum Galactomannan and (1→3)-β-D-Glucan Testing for Rapid Detection of Fungal Peritonitis

Session Information

Category: Dialysis

  • 703 Dialysis: Peritoneal Dialysis

Authors

  • Kanjanabuch, Talerngsak, Medicine, Pathumwan, Thailand
  • Chamroensakchai, Tamonwan, chulalongkorn hospital, Bangkok, Thailand
  • Saejew, Thunvarat, chulalongkorn hospital, Bangkok, Thailand
Background

Fungal peritonitis is one of the most serious complications of peritoneal dialysis. Early detection of the causative organism is a key determining outcome; however, routine culture is time consuming and KOH staining has very low sensitivity. Hence serum (1→3)-β-D-glucan (BG) or galactomannan (GM), both fungal cell wall components, may be candidate biomarkers of fungal peritonitis.

Methods

A comparative multi-centered cross-sectional analysis of paired serum and peritoneal dialysis fluid (PDF) BG (Fungitell, Cape Cod, MA, USA) and GM (Platelia Aspergillus Ag kits, Bio-rad, France) from all PD patients with and without fungal peritonitis (23 cases, 8 cases with bacteria and 23 cases control identified by culture), over a 1 year period, was performed.

Results

PDF and serum of the fungal peritonitis group showed very high GM (2.42±2.15, 1.85±1.22) and BG (410.0±158.3, 355.9±246.9) compared to bacterial peritonitis (0.28±0.12, 0.34±0.14), (7.81±0, 7.81 ±0) and healthy control (0.42±0.16, 0.39±0.10), (7.81 ± 0, 7.81±0), respectively. A GM cut-off value at at 0.5 and BG at 80 pg/ml. showed positive predictive value (PPV) of GM test was 95.45% and negative predictive value (NPV) was 93.75%. The sensitivity and specificity of GM testing in PDF and serum were 91.3% and 96.8% respectively.

Conclusion

BG and GM in peritoneal dialysis fluid and serum with provisional cut-off values were applicable as surrogate biomarkers for the diagnosis of fungal peritonitis in PD patients.