Diagnostic value of combined detection of BDG,GAL,lymphocyte count,and CD4+T cells for invasive fungal infection in sepsis patients

ZHANG Jin-hua; FAN Hai-bo; WANG Lei; YAO Xiao-ming; SHI Jian-feng; WANG Zhi-guo

doi:10.13820/j.cnki.gdyx.20251510

Abstract：Objective To analyze lymphocyte subsets and serum BDG and GAL levels in patients with sepsis complicated by invasive fungal infection(IFI),and to explore the correlation between T lymphocyte profiles and IFI.Methods A retrospective case-control study was conducted,including 47 patients with sepsis and secondary IFI(sep-sis+IFI group),50 patients with sepsis alone(sepsis group),and 50 healthy controls.Serum(1,3)-β-D-glucan(BDG)was measured by immunoturbidimetry,and galactomannan(GAL)was detected using ELISA.Peripheral white blood cells were analyzed by an automated hematology analyzer,and lymphocyte subsets were assessed using flow cytome-try.Group differences were compared,correlations between lymphocyte subsets and BDG/GAL were analyzed using Spearman's method,and diagnostic performance was evaluated by receiver operating characteristic(ROC)curves.Re-sults Compared with controls,patients with sepsis and IFI had significantly lower absolute lymphocyte counts(P＜0.05).Spearman correlation analysis showed that BDG and GAL levels were negatively correlated with absolute CD45+lymphocyte and CD3+CD4+T-cell counts(BDG:r=-0.601,-0.507;GAL:r=-0.532,-0.612;all P＜0.05).ROC analysis revealed that the area under the curve(AUC)for diagnosing IFI using BDG+GAL,BDG+GAL+CD45+lymphocyte count,and BDG+GAL+CD45+lymphocyte count+CD3+CD4+T-cell count were 0.753,0.921,and 0.962,respectively.The corresponding sensitivities were 80.00％,80.85％,and 87.23％,and specificities were 60.00％,96.00％,and 98.00％.Conclusion Sepsis patients with IFI show significant immunosuppression,as indica-ted by reduced lymphocyte subsets.Combined detection of BDG,GAL,total lymphocyte count,and CD4+T-cell count provides high diagnostic accuracy for IFI in patients with sepsis.