000			02914na a2200301 4500
003			H12O
005			20210625062809.0
008			130622s2012 xxx||||| |||| 00| 0 eng d
040			_cH12O
041			_aeng
100			_aCatalán González, Mercedes _9871 _eMedicina Intensiva
100			_962 _aPalacio Pérez-Medel, Ángel del _eMedicina Interna
100			_91539 _aPalacio Hernanz, Amalia del _eMicrobiología
100			_aCruz Bértolo, Javier de la _91783 _eEpidemiología Clínica
100			_aMontejo González, Juan Carlos _9874 _eMedicina Intensiva
245	0	0	_aProspective study in critically ill non-neutropenic patients: diagnostic potential of (1,3)-β-D-glucan assay and circulating galactomannan for the diagnosis of invasive fungal disease _h[artículo]
260			_bEuropean Journal of Clinical Microbiology and Infectious Diseases, _c2012
300			_a31(5):721-731.
500			_aFormato Vancouver: Acosta J, Catalán M, del Palacio-Pérez-Medel A, Montejo JC, De-La-Cruz-Bértolo J, Moragues MD, et al. Prospective study in critically ill non-neutropenic patients: diagnostic potential of (1,3)-β-D-glucan assay and circulating galactomannan for the diagnosis of invasive fungal disease. Eur J Clin Microbiol Infect Dis. 2012;31(5):721-31.
501			_aPMID: 21811868
504			_aContiene 50 referencias
520			_aDiagnosis of invasive fungal disease (IFD) in patients under intensive care is challenging. Circulating biomarkers, (1,3)-β-D-glucan (BG) and galactomannan (GM), were prospectively assessed in 98 critically ill patients at risk of IFD. There were 11 cases of invasive aspergillosis (IA; 4 proven and 7 probable), 9 cases of proven invasive candidiasis (IC), 1 case of mixed proven IC and probable IA, 1 case of proven zygomycosis, and 1 case of mixed mycelial proven IFD. In all IA cases there was no significant difference when the area under the receiver operating characteristic curve (AUC) of GM (0.873 [95%CI, 0.75-0.99]) and BG (0.856 [95% CI, 0.71-0.99]) were compared (p = 0.871). The AUC for BG in IC and for the rest of the IFD cases was 0.605 (95% CI, 0.39-0.82) and 0.768 (95% CI, 0.63-0.90) respectively. Positive BG (40%) predated blood culture (n = 3) and abdominal pus (n = 1) a mean of 3.25 days before Candida was grown. In patients with IFD caused by molds, BG appeared a mean of 5.65 days before culture results. For the diagnosis of patients at risk of IC, BG has shown a high NPV (94.5%), with positive results also predating blood cultures in 30% of patients. In conclusion, early BG results permit a timely initiation of antifungal therapy in patients at risk of IFD.
710			_96 _aServicio de Medicina Interna
710			_967 _aServicio de Medicina Intensiva
710			_9625 _aInstituto de Investigación imas12
856			_uhttp://pc-h12o-es.m-hdoct.a17.csinet.es/pdf/pc/9/pc9110.pdf _ySolicitar documento
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999			_c9110 _d9110