Session Type: ePosters
Session Title: ePosters
Authors(s): R. Tsui, V. Wong
Authors Affiliations(s): Cambridge University Hospitals NHS Foundation Trust, United Kingdom
Background:
Invasive fungal infections are increasingly a major cause of morbidity and mortality in predominantly immunocompromised patients. Diagnosis of fungal infection is often challenging due to variable clinical presentations and current culture-based methods requiring long incubation times. Serum beta-(1,3)-D-glucan (BDG), a fungal cell wall antigen, is used as a rapid biomarker assay in clinical practice to assess likelihood of fungal infection. We retrospectively reviewed the clinical impact of the BDG result in a case series of patients at a large tertiary healthcare centre.
Case:We retrospectively reviewed the cases of 10 inpatients with BDG results at Cambridge University Hospital, from April 2018 to October 2019. Data was collated on demographic details, past medical history, risk factors for infection, treatment regimens, adverse drug events (ADEs) and outcomes.
Ten patients were selected for this case review (eight adults; two children). They had a range of underlying medical backgrounds, including lymphoma, leukaemia, autoimmune connective tissue disease, Good’s syndrome, acute liver disease, liver transplants, diabetes and intravenous drug use. Risk factors for fungal infection included prolonged courses of intravenous antibiotics and central venous lines (10/10). Eight patients were receiving immunosuppressive medication, two patients had recent abdominal surgery and one had pancreatitis. Three patients had antifungals stopped due to negative BDG with no adverse outcomes. Of the seven patients with positive BDGs all were treated with appropriate antifungals: two had confirmed Pneumocystis pneumonia; one had confirmed Candida endophthalmitis; and four had no microbiological diagnosis, but evidence of fungal infection on radiology. There were no ADEs from the treatment. At 3 month follow-up seven patients were well and two had died, but not from their fungal infections (bacterial pneumonia; acute myeloid leukaemia). One further patient was still receiving treatment for fungal skull-base osteomyelitis but she subsequently died of her underlying condition.
Discussion:A clear diagnosis is vital as antifungal treatment carries risk of harm to the patient, is costly, and may drive antifungal resistance. This case series demonstrates the clinical utility of BDG in the assessment of patients at risk of invasive fungal disease. However, more large scale collaborative analyses are required to produce guidelines and optimise management.
Keyword(s): Beta-D-glucan, Fungal, BiomarkersSession Type: ePosters
Session Title: ePosters
Authors(s): R. Tsui, V. Wong
Authors Affiliations(s): Cambridge University Hospitals NHS Foundation Trust, United Kingdom
Background:
Invasive fungal infections are increasingly a major cause of morbidity and mortality in predominantly immunocompromised patients. Diagnosis of fungal infection is often challenging due to variable clinical presentations and current culture-based methods requiring long incubation times. Serum beta-(1,3)-D-glucan (BDG), a fungal cell wall antigen, is used as a rapid biomarker assay in clinical practice to assess likelihood of fungal infection. We retrospectively reviewed the clinical impact of the BDG result in a case series of patients at a large tertiary healthcare centre.
Case:We retrospectively reviewed the cases of 10 inpatients with BDG results at Cambridge University Hospital, from April 2018 to October 2019. Data was collated on demographic details, past medical history, risk factors for infection, treatment regimens, adverse drug events (ADEs) and outcomes.
Ten patients were selected for this case review (eight adults; two children). They had a range of underlying medical backgrounds, including lymphoma, leukaemia, autoimmune connective tissue disease, Good’s syndrome, acute liver disease, liver transplants, diabetes and intravenous drug use. Risk factors for fungal infection included prolonged courses of intravenous antibiotics and central venous lines (10/10). Eight patients were receiving immunosuppressive medication, two patients had recent abdominal surgery and one had pancreatitis. Three patients had antifungals stopped due to negative BDG with no adverse outcomes. Of the seven patients with positive BDGs all were treated with appropriate antifungals: two had confirmed Pneumocystis pneumonia; one had confirmed Candida endophthalmitis; and four had no microbiological diagnosis, but evidence of fungal infection on radiology. There were no ADEs from the treatment. At 3 month follow-up seven patients were well and two had died, but not from their fungal infections (bacterial pneumonia; acute myeloid leukaemia). One further patient was still receiving treatment for fungal skull-base osteomyelitis but she subsequently died of her underlying condition.
Discussion:A clear diagnosis is vital as antifungal treatment carries risk of harm to the patient, is costly, and may drive antifungal resistance. This case series demonstrates the clinical utility of BDG in the assessment of patients at risk of invasive fungal disease. However, more large scale collaborative analyses are required to produce guidelines and optimise management.
Keyword(s): Beta-D-glucan, Fungal, Biomarkers
Session Type: ePosters
Session Title: ePosters
Authors(s): R. Tsui, V. Wong
Authors Affiliations(s): Cambridge University Hospitals NHS Foundation Trust, United Kingdom
Background:
Invasive fungal infections are increasingly a major cause of morbidity and mortality in predominantly immunocompromised patients. Diagnosis of fungal infection is often challenging due to variable clinical presentations and current culture-based methods requiring long incubation times. Serum beta-(1,3)-D-glucan (BDG), a fungal cell wall antigen, is used as a rapid biomarker assay in clinical practice to assess likelihood of fungal infection. We retrospectively reviewed the clinical impact of the BDG result in a case series of patients at a large tertiary healthcare centre.
Case:We retrospectively reviewed the cases of 10 inpatients with BDG results at Cambridge University Hospital, from April 2018 to October 2019. Data was collated on demographic details, past medical history, risk factors for infection, treatment regimens, adverse drug events (ADEs) and outcomes.
Ten patients were selected for this case review (eight adults; two children). They had a range of underlying medical backgrounds, including lymphoma, leukaemia, autoimmune connective tissue disease, Good’s syndrome, acute liver disease, liver transplants, diabetes and intravenous drug use. Risk factors for fungal infection included prolonged courses of intravenous antibiotics and central venous lines (10/10). Eight patients were receiving immunosuppressive medication, two patients had recent abdominal surgery and one had pancreatitis. Three patients had antifungals stopped due to negative BDG with no adverse outcomes. Of the seven patients with positive BDGs all were treated with appropriate antifungals: two had confirmed Pneumocystis pneumonia; one had confirmed Candida endophthalmitis; and four had no microbiological diagnosis, but evidence of fungal infection on radiology. There were no ADEs from the treatment. At 3 month follow-up seven patients were well and two had died, but not from their fungal infections (bacterial pneumonia; acute myeloid leukaemia). One further patient was still receiving treatment for fungal skull-base osteomyelitis but she subsequently died of her underlying condition.
Discussion:A clear diagnosis is vital as antifungal treatment carries risk of harm to the patient, is costly, and may drive antifungal resistance. This case series demonstrates the clinical utility of BDG in the assessment of patients at risk of invasive fungal disease. However, more large scale collaborative analyses are required to produce guidelines and optimise management.
Keyword(s): Beta-D-glucan, Fungal, BiomarkersSession Type: ePosters
Session Title: ePosters
Authors(s): R. Tsui, V. Wong
Authors Affiliations(s): Cambridge University Hospitals NHS Foundation Trust, United Kingdom
Background:
Invasive fungal infections are increasingly a major cause of morbidity and mortality in predominantly immunocompromised patients. Diagnosis of fungal infection is often challenging due to variable clinical presentations and current culture-based methods requiring long incubation times. Serum beta-(1,3)-D-glucan (BDG), a fungal cell wall antigen, is used as a rapid biomarker assay in clinical practice to assess likelihood of fungal infection. We retrospectively reviewed the clinical impact of the BDG result in a case series of patients at a large tertiary healthcare centre.
Case:We retrospectively reviewed the cases of 10 inpatients with BDG results at Cambridge University Hospital, from April 2018 to October 2019. Data was collated on demographic details, past medical history, risk factors for infection, treatment regimens, adverse drug events (ADEs) and outcomes.
Ten patients were selected for this case review (eight adults; two children). They had a range of underlying medical backgrounds, including lymphoma, leukaemia, autoimmune connective tissue disease, Good’s syndrome, acute liver disease, liver transplants, diabetes and intravenous drug use. Risk factors for fungal infection included prolonged courses of intravenous antibiotics and central venous lines (10/10). Eight patients were receiving immunosuppressive medication, two patients had recent abdominal surgery and one had pancreatitis. Three patients had antifungals stopped due to negative BDG with no adverse outcomes. Of the seven patients with positive BDGs all were treated with appropriate antifungals: two had confirmed Pneumocystis pneumonia; one had confirmed Candida endophthalmitis; and four had no microbiological diagnosis, but evidence of fungal infection on radiology. There were no ADEs from the treatment. At 3 month follow-up seven patients were well and two had died, but not from their fungal infections (bacterial pneumonia; acute myeloid leukaemia). One further patient was still receiving treatment for fungal skull-base osteomyelitis but she subsequently died of her underlying condition.
Discussion:A clear diagnosis is vital as antifungal treatment carries risk of harm to the patient, is costly, and may drive antifungal resistance. This case series demonstrates the clinical utility of BDG in the assessment of patients at risk of invasive fungal disease. However, more large scale collaborative analyses are required to produce guidelines and optimise management.
Keyword(s): Beta-D-glucan, Fungal, Biomarkers