EVALUATION OF PLASMA (1-]3)-BETA-D-GLUCAN MEASUREMENT BY THE KINETIC TURBIDIMETRIC LIMULUS TEST, FOR THE CLINICAL-DIAGNOSIS OF MYCOTIC INFECTIONS

The present multicentre clinical study was conducted to assess the cli nical utility of a new diagnostic method for deep mycosis in which (1- ->3)-beta-D-glucan, a fungal cell wall component existing in plasma, w as quantitatively measured by the kinetic turbidimetric Limulus test ( WB003). Plasma (1-->3)-beta-D-glucan concentrations were 0.57 +/- 0.10 mu g/l in 92 healthy subjects and 0.62 +/- 0.32 mu g/l in 26 patients with non-mycotic diseases (disease control group). In comparison with these healthy subjects and patients with non-mycotic diseases, patien ts with mycosis had significantly higher plasma (1-->3)-beta-D-glucan concentrations: 19.63 +/- 73.28 mu g/l in 12 patients with candidaemia , 11.28 +/- 21.42 mu g/l in 7 patients with urinary Candida infection, 4.84 +/- 12.71 mu g/l in 5 patients with pulmonary candidiasis, and 1 2.21 +/- 31.31 mu g/l in 4 patients with invasive pulmonary aspergillo sis. On the statistical analysis of these data, a cut-off value was se t at 1.0 mu g/l. Using this cut-off value, 3 patients with pulmonary c ryptococcosis and 4 patients (4/6) with pulmonary aspergilloma were al l negative with low plasma (1-->3)-beta-D-glucan levels. The test WB00 3 provided equivalent or higher efficiency of diagnosis of candidiasis and aspergillosis, in comparison with commercially available antigen detection kits, demonstrating its utility as a diagnostic reagent. It may also be useful in assessing therapeutic effectiveness when used pe riodically after treatment.