M. Zhaoa (Dr), S. Yanga (Dr), J. Li*b (Dr)

a Department of pulmonary and Critical Care Medicine, Guangdong provincial people’s hospital, Guangzhou, CHINA ; b Department of pulmonary and Critical Care Medicine, Guangdong provincial people’s hospital, Guangzhou, 510080, China, Guangzhou, CHINA

* dr.lijing@gdph.org.cn

Background: In order to enhance the accuracy of pulmonary fungal infection diagnosis, the level of (1-3)-β-D glucan in serum has been used in clinical work to assist in the fungal infection diagnosis. However, as a diagnostic test, serum fungal (1-3)-β-D glucan has the characteristics of poor diagnostic sensitivity and specificity. At the same time, it is unclear if the (1-3)-β-D glucan level in bronchoalveolar lavage fluid through fiberoptic bronchoscopy is more accurate in diagnosing pulmonary infection.

Methods: A retrospective study was performed in Guangdong Provincial People's Hospital from January 1, 2018 to December 31, 2021, with the cases who underwent bronchoscopic alveolar lavage due to pulmonary lesions and tested for (1-3)-β-D glucan with bronchoalveolar lavage fluid. Besides the (1-3)-β-D glucan test results, clinical data as well as their diagnosis were recorded from electronic medical record system.

Results: There were 1228 patients enrolled. Among them,108 cases were finally diagnosed with pulmonary fungal infection. Patients with confirmed pulmonary fungal infection had significantly higher (1-3)-β-D glucan levels than patients with other diseases (189.9 ± 47.0 and 53.3 ± 4.4 pg/ml) , the area under the curve (AUC) was 0.64. At the same time, 1006 of these patients were also received plasma (1-3)-β-D glucan testing, 100 patients were diagnosed with pulmonary fungal infections. Plasma (1-3)-β-D glucan was significantly elevated in patients with pulmonary fungal infection (158.2 ± 60.9 and 41.7 ± 8.0 pg/ml) compared with patients with a final diagnosis of other diseases, the AUC of plasma (1-3)-β-D glucan was 0.597.

Conclusion: We found that (1-3)-β-glucan in bronchoalveolar lavage fluid was slightly more diagnostic than plasma. Furthermore, clinical features and imaging features have to be combined to diagnose pulmonary fungal infection in the furture work.

Disclosure of funding source(s): none