{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T04:32:16Z","timestamp":1785472336917,"version":"3.56.0"},"reference-count":60,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2020,9,17]],"date-time":"2020-09-17T00:00:00Z","timestamp":1600300800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Mycoses"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Rapid and reliable exclusion of invasive fungal infections (IFI) by markers able to avoid unnecessary empirical antifungal treatment is still a critical unmet clinical need. We investigated the diagnostic performance of a newly available <jats:italic>\u03b2<\/jats:italic>\u2010<jats:sc>d<\/jats:sc>\u2010Glucan (BDG) quantification assay, focusing on the optimisation of the BDG cut\u2010off values for IFI exclusion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>BDG results by Wako \u03b2\u2010glucan assay (lower limit of detection [LLOD]\u00a0=\u00a02.16\u00a0pg\/mL, positivity\u00a0\u2265\u00a011\u00a0pg\/mL) on two consecutive serum samples were retrospectively analysed in 170 patients, admitted to haematological wards (N\u00a0=\u00a042), intensive care units (ICUs; N\u00a0=\u00a080), or other wards (N\u00a0=\u00a048), exhibiting clinical signs and\/or symptoms suspected for IFI. Only patients with proven IFI (EORTC\/MSG criteria) were considered as true positives in the assessment of BDG sensitivity, specificity and predictive values.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patients were diagnosed with no IFI (69.4%), proven IFI (25.3%) or probable IFI (5.3%). Two consecutive BDG values\u00a0&lt;\u00a0LLOD performed within a median of 1 (interquartile range: 1\u20103) day were able to exclude a proven IFI with 100% sensitivity and negative predictive value (primary study goal). Test's specificity improved by using two distinct positivity and negativity cut\u2010offs (7.7\u00a0pg\/mL and LLOD, respectively), but remained suboptimal in ICU patients (50%), as compared to haematological or other patients (93% and 90%, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The classification of Wako's results as negative when\u00a0&lt;\u00a0LLOD, and positive when\u00a0&gt;\u00a07.7\u00a0pg\/mL, could be a promising diagnostic approach to confidently rule out an IFI in both ICU and non\u2010ICU patients. The poor specificity in the ICU setting remains a concern, due to the difficulty to interpret positive results in this fragile population.<\/jats:p><\/jats:sec>","DOI":"10.1111\/myc.13170","type":"journal-article","created":{"date-parts":[[2020,8,28]],"date-time":"2020-08-28T06:22:37Z","timestamp":1598595757000},"page":"1299-1310","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Quantification of 1,3\u2010\u03b2\u2010<scp>d<\/scp>\u2010glucan by Wako \u03b2\u2010glucan assay for rapid exclusion of invasive fungal infections in critical patients: A diagnostic test accuracy study"],"prefix":"10.1111","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3272-4252","authenticated-orcid":false,"given":"Valeria","family":"Cento","sequence":"first","affiliation":[{"name":"Resident in Microbiology and Virology Universit\u00e0 degli Studi di Milano Milan 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