Diagnostic value and correlation analysis of(1,3)-β-D glucan combined with inflammatory markers in can-didemia

WU Jie; CAO Yang; ZHANG Yanwei; XING Baobao; REN Zhihong; ZHAO Jianping; ZHAO Yanan; HE Juan; DUAN Huijuan

doi:10.3969/j.issn.1673-3827.2025.04.007

Abstract：Objective To explore the diagnostic value and correlation of the(1,3)-β-D glucan test(G test)combined with procalcitonin and C-reactive protein in Candida spp.bloodstream infections,in order to provide theoretical basis for the ear-ly diagnosis of candidemia.Method Thirty-seven patients diagnosed with Candida infection through blood culture at Inner Mongolia Autonomous Region People's Hospital from July 2019 to December 2023 were collected as the fungal group,and 206 patients with negative blood culture were randomly collected as the control group during the same period.The diagnostic value and correlation of G test,PCT,CRP and their combined detection were retrospectively analyzed,and the clinical char-acteristics of different candidemia groups were compared.Result Among the 37 cases in the fungal group,the primary de-partment distribution was ICU(45.95%).The average levels of age,G test,and PCT in the 37 treatment groups were 81.00 years old,87.82 pg/mL,and 1.39 ng/mL respectively,which were significantly higher than those in the 206 control groups(70.50 years old,37.50 pg/mL,and 0.431.39 ng/mL),with statistical significance(P<0.05).However,CRP had no statistical significance between the two groups(P>0.05).The correlation coefficient between G test and PCT was 0.266,and there was a weak correlation between the two(P<0.05);The correlation coefficient between PCT and CRP was 0.35,indicating a moderate strength correlation(P<0.05);There was no significant correlation between G test and CRP(P=0.168).The area under the ROC curve,sensitivity,and specificity for the diagnosis of candidemia were 0.839,0.784,and 0.84 for the G test alone(with a critical value of 41.96 pg/mL);The PCTs were tested separately at 0.720,0.703,and 0.655(with a critical value of 0.755ng/mL);When conducting G test and PCT combined detections:0.860,0.811,0.845.The average PCT level in the Candida albicans group was 7.35 ng/mL,which was higher than 0.625 ng/mL in other Can-dida groups,and the difference was statistically significant(P=0.007).Conclusion Candidemia patients tend to be older and mainly originated from the ICU,with elevated levels of G-test and PCT.The G-test and PCT have a certain degree of correlation;their combined detection significantly enhances the early diagnostic value for candidemia,improving the sensitivi-ty and specificity of individual tests.Most cases of candidemia are caused by Candida albicans,but there has been an in-creasing trend in non-Candida albicans infections in recent years.In the prevention and treatment of candidemia,attention should be paid to the high infection rate in ICU and the avoidance of mixed infections.