Abstract:
Objective To assess the role of G test in clinical diagnosis of invasive pulmonary fungal infection (IPFI) in kidney transplantation recipients.
Methods Clinical data about 127 kidney transplantation recipients admitted to Chinese PLA 309 Hospital from October 2008 to January 2013 were retrospectively analyzed. The patients were divided into IPFI group (n=24) and non-IPFI group (n=103). Their plasma (1, 3)-β-D glucan levels were measured. ROC curves were plotted for the diagnosis of IPFI in kidney transplantation recipients.
Results The mean plasma (1, 3)-β-D glucan level was significantly higher in IPFI group than in non-IPFI group (79.51 pg/ml
vs 10 pg/ml,
P<0.001). G test showed that the area under the ROC curves was 0.795 and the optimal threshold value was 13.08 pg/ml for the diagnosis of IPFI in kidney transplantation recipients when CT demonstrated new infections, with a sensitivity of 0.778, a specificity of 0.861, a positive prediction value of 0.737, and a negative prediction value of 0.882. G test showed that the area under the ROC curves was 0.897 and the optimal threshold value was 13.08 pg/ml for the diagnosis of IPFI in kidney transplantation recipients when CT displayed no new infections, with a sensitivity of 0.833, a specificity of 0.940, a positive prediction value of 0.556, and a negative prediction value of 0.984.
Conclusion G test is simple and effective for the diagnosis of IPFI in kidney transplantation recipients with an optimal threshold value of 13.08 pg/ml and 38.65 pg/ml, respectively, when CT shows no new infections.