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How to interpret serum levels of beta-glucan for the diagnosis of invasive fungal infections in adult high-risk hematology patients: optimal cut-off levels and confounding factors

Overview of attention for article published in European Journal of Clinical Microbiology & Infectious Diseases, January 2015
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Title
How to interpret serum levels of beta-glucan for the diagnosis of invasive fungal infections in adult high-risk hematology patients: optimal cut-off levels and confounding factors
Published in
European Journal of Clinical Microbiology & Infectious Diseases, January 2015
DOI 10.1007/s10096-014-2302-9
Pubmed ID
Authors

H. Hammarström, N. Kondori, V. Friman, C. Wennerås

Abstract

Detection of the fungal cell wall component beta-glucan (BG) in serum is increasingly used to diagnose invasive fungal infections (IFI), but its optimal use in hematology patients with high risk of IFI is not well defined. We retrospectively analyzed the diagnostic accuracy, optimal cut-off level, and potential confounding factors of BG reactivity. The inclusion criteria were: adult patients with hematologic disease who were admitted to the hematology ward during the 2-year study period and who had two or more consecutive BG assays performed. In total, 127 patients were enrolled. Thirteen patients with proven or probable IFI, as defined by the 2008 European Organization for Research and Treatment of Cancer/Mycoses Study Group (EORTC/MSG) criteria, were identified. Receiver operating characteristic (ROC) curve analysis showed a high overall diagnostic performance (area under the ROC curve = 0.98) and suggested an optimal cut-off level of 158 pg/ml, with a sensitivity and a specificity of 92 % and 96 %, respectively. Multiway analysis of variance indicated that treatment with pegylated asparaginase (p < 0.001), admission to the intensive care unit (ICU; p = 0.0007), and treatment with albumin, plasma, or coagulation factors (p = 0.01) are potential confounding factors of BG reactivity. We propose that a higher cut-off level than that recommended by the manufacturer should be used to monitor adult hematology patients at high risk for IFI. Our results also suggest that elevated BG levels in patients treated with pegylated asparaginase, albumin, plasma, or coagulation factors, or those admitted to the ICU should be interpreted with caution.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 29 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United States 1 3%
Australia 1 3%
Unknown 27 93%

Demographic breakdown

Readers by professional status Count As %
Researcher 6 21%
Student > Doctoral Student 4 14%
Other 3 10%
Lecturer 2 7%
Student > Master 2 7%
Other 5 17%
Unknown 7 24%
Readers by discipline Count As %
Medicine and Dentistry 8 28%
Biochemistry, Genetics and Molecular Biology 4 14%
Agricultural and Biological Sciences 3 10%
Pharmacology, Toxicology and Pharmaceutical Science 2 7%
Philosophy 1 3%
Other 2 7%
Unknown 9 31%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 09 January 2015.
All research outputs
#14,666,124
of 22,776,824 outputs
Outputs from European Journal of Clinical Microbiology & Infectious Diseases
#1,763
of 2,769 outputs
Outputs of similar age
#195,317
of 352,043 outputs
Outputs of similar age from European Journal of Clinical Microbiology & Infectious Diseases
#21
of 44 outputs
Altmetric has tracked 22,776,824 research outputs across all sources so far. This one is in the 35th percentile – i.e., 35% of other outputs scored the same or lower than it.
So far Altmetric has tracked 2,769 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.6. This one is in the 35th percentile – i.e., 35% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 352,043 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 43rd percentile – i.e., 43% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 44 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 50% of its contemporaries.