Early serum (1->3)--D-glucan levels in patients with burn injury.

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Citation: Mycoses. 55(3):224-7, 2012 May.PMID: 21771107Institution: MedStar Washington Hospital CenterDepartment: Medicine/Infectious Diseases | Surgery/Burn ServicesForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *beta-Glucans/bl [Blood] | *Burns/co [Complications] | *Candidemia/bl [Blood] | Burns/bl [Blood] | Candida/ip [Isolation & Purification] | Candida/ph [Physiology] | Candidemia/di [Diagnosis] | Candidemia/et [Etiology] | Candidemia/mi [Microbiology] | Female | Humans | Prospective StudiesYear: 2012ISSN:
  • 0933-7407
Name of journal: MycosesAbstract: Serum (1->3)--D-glucan (BG) is increasingly used as diagnostic marker for invasive fungal infections. Exposure to gauze may lead to false-positive BG assays. The role of BG is unclear in thermally injured patients who frequently require extensive gauze coverage; therefore, we prospectively evaluated BG levels in burn-injured patients. Serum BG levels were measured in 18 burn patients immediately before application of the first dressing and 12 h after. Patients were stratified by extent of total body surface area (TBSA) requiring gauze coverage: <20%, 20-39%, 40-60% and >60%. BG levels were obtained from patients with non-burn trauma as controls. BG results were positive (>80 pg ml-1) in 9/18 (50%) patients at baseline and in 8/18 (44%) 12 h after application of the first dressing. BG levels were positive in 1/5 (20%) of patients with <20% TBSA requiring gauze and in 10/13 (77%) with >= 20% (P < 0.05). None of the control patients had positive BG at any time point and none of the patients had candidemia at baseline. Mean serum BG levels decreased (19.44 pg ml-1) after gauze placement. False-positive serum BG elevations are common in this patient population. Positivity correlates with extent of TBSA injured, but is not impacted by the gauze itself. 2011 Blackwell Verlag GmbH.All authors: Finkelman M, Jaskille AD, Jeng JC, Jordan MH, Kath MA, Matt SE, Nguyen do T, Pavlovich AR, Petraitiene R, Shoham S, Shupp JW, Walsh TJFiscal year: FY2012Digital Object Identifier: Date added to catalog: 2013-09-17
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Journal Article MedStar Authors Catalog Article 21771107 Available 21771107

Serum (1->3)--D-glucan (BG) is increasingly used as diagnostic marker for invasive fungal infections. Exposure to gauze may lead to false-positive BG assays. The role of BG is unclear in thermally injured patients who frequently require extensive gauze coverage; therefore, we prospectively evaluated BG levels in burn-injured patients. Serum BG levels were measured in 18 burn patients immediately before application of the first dressing and 12 h after. Patients were stratified by extent of total body surface area (TBSA) requiring gauze coverage: <20%, 20-39%, 40-60% and >60%. BG levels were obtained from patients with non-burn trauma as controls. BG results were positive (>80 pg ml-1) in 9/18 (50%) patients at baseline and in 8/18 (44%) 12 h after application of the first dressing. BG levels were positive in 1/5 (20%) of patients with <20% TBSA requiring gauze and in 10/13 (77%) with >= 20% (P < 0.05). None of the control patients had positive BG at any time point and none of the patients had candidemia at baseline. Mean serum BG levels decreased (19.44 pg ml-1) after gauze placement. False-positive serum BG elevations are common in this patient population. Positivity correlates with extent of TBSA injured, but is not impacted by the gauze itself. 2011 Blackwell Verlag GmbH.

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