PMID- 33477250
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20210218
IS  - 2309-608X (Electronic)
IS  - 2309-608X (Linking)
VI  - 7
IP  - 1
DP  - 2021 Jan 17
TI  - Utility of 1,3 beta-d-Glucan Assay for Guidance in Antifungal Stewardship Programs 
      for Oncologic Patients and Solid Organ Transplant Recipients.
LID - 10.3390/jof7010059 [doi]
LID - 59
AB  - The implementation of 1,3 beta-d-glucan (BDG) has been proposed as a diagnostic tool 
      in antifungal stewardship programs (ASPs). We aimed to analyze the influence of 
      serum BDG in an ASP for oncologic patients and solid organ transplant (SOT) 
      recipients. We conducted a pre-post study. In the initial period (PRE), the ASP 
      was based on bedside advice, and this was complemented with BDG in the 
      post-period (POST). Performance parameters of the BDG assay were determined. 
      Antifungal (AF) use adequacy was evaluated using a point score. Clinical outcomes 
      and AF costs were also compared before and after the intervention. Overall, 85 
      patients were included in the PRE-period and 112 in the POST-period. Probable or 
      proven fungal infections were similar in both groups (54.1% vs. 57.1%; p = 0.67). 
      The determination of BDG contributed to improved management in 75 of 112 patients 
      (66.9%). The AF adequacy score improved in the POST-period (mean 7.75 vs. 9.29; p 
      < 0.001). Median days of empiric AF treatment was reduced in the POST-period (9 
      vs. 5 days, p = 0.04). All-cause mortality (44.7% vs. 34.8%; p = 0.16) was 
      similar in both periods. The cost of AF treatments was reduced in the POST-period 
      with a difference of 779.6 euro/patient. Our data suggest that the use of BDG was a 
      cost-effective strategy that contributed to safely improving the results of an 
      ASP for SOT and oncologic patients.
FAU - Machado, Marina
AU  - Machado M
AUID- ORCID: 0000-0002-8370-2248
AD  - Clinical Microbiology and Infectious Diseases Department, Hospital General 
      Universitario Gregorio Maranon, 28007 Madrid, Spain.
AD  - Instituto de Investigacion Sanitaria Gregorio Maranon, 28007 Madrid, Spain.
AD  - Fundacion Mutua Madrilena Research Fellowship, 28046 Madrid, Spain.
FAU - Chamorro de Vega, Esther
AU  - Chamorro de Vega E
AD  - Instituto de Investigacion Sanitaria Gregorio Maranon, 28007 Madrid, Spain.
AD  - Pharmacy Department, Hospital General Universitario Gregorio Maranon, 28007 
      Madrid, Spain.
FAU - Martinez-Jimenez, Maria Del Carmen
AU  - Martinez-Jimenez MDC
AD  - Clinical Microbiology and Infectious Diseases Department, Hospital General 
      Universitario Gregorio Maranon, 28007 Madrid, Spain.
AD  - Fundacion Mutua Madrilena Research Fellowship, 28046 Madrid, Spain.
FAU - Rodriguez-Gonzalez, Carmen Guadalupe
AU  - Rodriguez-Gonzalez CG
AD  - Instituto de Investigacion Sanitaria Gregorio Maranon, 28007 Madrid, Spain.
AD  - Pharmacy Department, Hospital General Universitario Gregorio Maranon, 28007 
      Madrid, Spain.
FAU - Vena, Antonio
AU  - Vena A
AUID- ORCID: 0000-0002-0697-3992
AD  - Clinical Microbiology and Infectious Diseases Department, Hospital General 
      Universitario Gregorio Maranon, 28007 Madrid, Spain.
FAU - Navarro, Raquel
AU  - Navarro R
AD  - Clinical Microbiology and Infectious Diseases Department, Hospital General 
      Universitario Gregorio Maranon, 28007 Madrid, Spain.
FAU - Zamora-Cintas, Maria Isabel
AU  - Zamora-Cintas MI
AD  - Clinical Microbiology and Infectious Diseases Department, Hospital General 
      Universitario Gregorio Maranon, 28007 Madrid, Spain.
FAU - Agnelli, Caroline
AU  - Agnelli C
AD  - Clinical Microbiology and Infectious Diseases Department, Hospital General 
      Universitario Gregorio Maranon, 28007 Madrid, Spain.
FAU - Olmedo, Maria
AU  - Olmedo M
AD  - Clinical Microbiology and Infectious Diseases Department, Hospital General 
      Universitario Gregorio Maranon, 28007 Madrid, Spain.
AD  - Instituto de Investigacion Sanitaria Gregorio Maranon, 28007 Madrid, Spain.
FAU - Galar, Alicia
AU  - Galar A
AD  - Clinical Microbiology and Infectious Diseases Department, Hospital General 
      Universitario Gregorio Maranon, 28007 Madrid, Spain.
AD  - Instituto de Investigacion Sanitaria Gregorio Maranon, 28007 Madrid, Spain.
FAU - Guinea, Jesus
AU  - Guinea J
AUID- ORCID: 0000-0002-7901-8355
AD  - Clinical Microbiology and Infectious Diseases Department, Hospital General 
      Universitario Gregorio Maranon, 28007 Madrid, Spain.
AD  - Instituto de Investigacion Sanitaria Gregorio Maranon, 28007 Madrid, Spain.
AD  - CIBER Enfermedades Respiratorias, CIBERES (CB06/06/0058), 28029 Madrid, Spain.
FAU - Fernandez-Cruz, Ana
AU  - Fernandez-Cruz A
AD  - Clinical Microbiology and Infectious Diseases Department, Hospital General 
      Universitario Gregorio Maranon, 28007 Madrid, Spain.
FAU - Alonso, Roberto
AU  - Alonso R
AD  - Clinical Microbiology and Infectious Diseases Department, Hospital General 
      Universitario Gregorio Maranon, 28007 Madrid, Spain.
AD  - Departamento de Medicina, Facultad de Medicina, Universidad Complutense de 
      Madrid, 28040 Madrid, Spain.
FAU - Bouza, Emilio
AU  - Bouza E
AD  - Clinical Microbiology and Infectious Diseases Department, Hospital General 
      Universitario Gregorio Maranon, 28007 Madrid, Spain.
AD  - Instituto de Investigacion Sanitaria Gregorio Maranon, 28007 Madrid, Spain.
AD  - CIBER Enfermedades Respiratorias, CIBERES (CB06/06/0058), 28029 Madrid, Spain.
AD  - Departamento de Medicina, Facultad de Medicina, Universidad Complutense de 
      Madrid, 28040 Madrid, Spain.
FAU - Munoz, Patricia
AU  - Munoz P
AUID- ORCID: 0000-0001-5706-5583
AD  - Clinical Microbiology and Infectious Diseases Department, Hospital General 
      Universitario Gregorio Maranon, 28007 Madrid, Spain.
AD  - Instituto de Investigacion Sanitaria Gregorio Maranon, 28007 Madrid, Spain.
AD  - CIBER Enfermedades Respiratorias, CIBERES (CB06/06/0058), 28029 Madrid, Spain.
AD  - Departamento de Medicina, Facultad de Medicina, Universidad Complutense de 
      Madrid, 28040 Madrid, Spain.
FAU - Valerio, Maricela
AU  - Valerio M
AD  - Clinical Microbiology and Infectious Diseases Department, Hospital General 
      Universitario Gregorio Maranon, 28007 Madrid, Spain.
AD  - Instituto de Investigacion Sanitaria Gregorio Maranon, 28007 Madrid, Spain.
AD  - Fundacion Mutua Madrilena Research Fellowship, 28046 Madrid, Spain.
LA  - eng
GR  - PI13/01148/Instituto de Salud Carlos III Madrid Spain. European Regional 
      Development Fund (FEDER) "A way of making Europe"/
GR  - No Grant Numer/Fundacion Mutua Madrilena/
PT  - Journal Article
DEP - 20210117
PL  - Switzerland
TA  - J Fungi (Basel)
JT  - Journal of fungi (Basel, Switzerland)
JID - 101671827
PMC - PMC7830184
OTO - NOTNLM
OT  - 1,3 beta-d-glucan
OT  - antifungal stewardship
OT  - antifungals
OT  - biomarkers
OT  - invasive fungal infections
OT  - oncologic patients
OT  - solid organ transplant
COIS- M.M. reports personal speaker fees from Pfizer, outside the submitted work. P.M. 
      reports personal fees from Astellas, Pfizer, and Gilead, outside the submitted 
      work. M.V. reports personal speaker fees from GSK, Pfizer, and MSD, outside the 
      submitted work. A.F.-C. reports personal speaker fees from Astellas, MSD, Pfizer, 
      and Gilead, outside the submitted work. JG reports grants from Basilea Ltd, 
      grants from, Scynexis, grants from F2G, personal fees from Pfizer, personal fees 
      from Gilead, personal fees from United Medical, outside the submitted work. 
      E.C.d.V., M.d.C.M.-J., C.G.R.-G., A.V., R.N., M.I.Z.-C., C.A., M.O., A.G., R.A., 
      and E.B. declare no conflict of interest.
EDAT- 2021/01/23 06:00
MHDA- 2021/01/23 06:01
PMCR- 2021/01/17
CRDT- 2021/01/22 01:01
PHST- 2020/11/30 00:00 [received]
PHST- 2020/12/25 00:00 [revised]
PHST- 2021/01/11 00:00 [accepted]
PHST- 2021/01/22 01:01 [entrez]
PHST- 2021/01/23 06:00 [pubmed]
PHST- 2021/01/23 06:01 [medline]
PHST- 2021/01/17 00:00 [pmc-release]
AID - jof7010059 [pii]
AID - jof-07-00059 [pii]
AID - 10.3390/jof7010059 [doi]
PST - epublish
SO  - J Fungi (Basel). 2021 Jan 17;7(1):59. doi: 10.3390/jof7010059.