Effect of G test combined with urinary fungal culture on diagnostic efficacy of invasive fungal infections in the urinary system
LIU Jin1, SHAO Guojie1, ZHOU Xin1, ZHANG Jiaxia1, ZHANG Jingjing2
1. Department of Clinical Laboratory, 2. Department of Infectious Diseases,Characteristic Medical Center of the Chinese People’s Armed Police Force, Tianjin 300162,China
Abstract：Objective To study the effect of (1, 3) - beta-D glucan detection (G test) combined with urinary fungal culture on the diagnostic efficacy of invasive fungal infection (IFI) in the urinary system. Methods One hundred and thirty-five suspected cases of urinary IFI treated in our hospital between May 2019 and October 2020 were selected as the subjects. Serum samples and clean urine samples were collected from each of the patients. Serum G test was conducted via the MB-80 microbial rapid dynamic detection system and urinary fungi culture was carried out. Clinical symptoms, imaging diagnosis, use of antibiotics and prognosis of corresponding symptoms were used as the diagnostic criteria for IFI. The results of G test and urinary fungus culture test were recorded, and the sensitivity, specificity and accuracy of the two diagnostic methods used alone or in combination were analyzed. Results A total of 135 suspected urinary IFI patients were diagnosed with urinary IFI, 52 of whom were diagnosed with urinary IFI. Among these patients, 63 were urinary IFI positive by fungal culture and 64 by G test. 43 were urinary IFI positive by G test combined with fungal culture. A total of 63 strains of fungi were detected in urinary fungi culture, and the dominating one was Candida albicans that accounted for 71.43% (45/63). The sensitivity of G test combined with urinary fungi culture in diagnosing urinary IFI [80.77% (42/52)] and NPV [89.13% (82/92)] was not significantly different from that of the two diagnostic methods when used alone (P>0.05). The specificity, accuracy and PPV of G test combined with urinary fungi culture in diagnosing urinary IFI were [98.80% (82/83)] [91.85% (124/135)]and [97.67% (42/43)]respectively. The Youden index (0.796) was higher than when the two diagnostic methods were used alone (P＜0.05). Conclusions Candida albicans is the main pathogenic fungus of urinary IFI. G test combined with urinary fungus culture in clinical diagnosis of urinary IFI can significantly improve the diagnostic specificity, accuracy and positive predictive value.
刘锦, 邵国杰, 周鑫, 张佳侠, 张晶晶. G试验联合尿真菌培养对泌尿系侵袭性真菌感染诊断效能的影响[J]. 武警医学, 2021, 32(11): 921-924.
LIU Jin, SHAO Guojie, ZHOU Xin, ZHANG Jiaxia, ZHANG Jingjing. Effect of G test combined with urinary fungal culture on diagnostic efficacy of invasive fungal infections in the urinary system. Med. J. Chin. Peop. Armed Poli. Forc., 2021, 32(11): 921-924.
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