XXXX (1,3)-Beta-D-Glucan for the Diagnosis of F @entity30106 Associated with Contaminated Methylprednisolone Injections.

@entity1 @entity30106 @entity693 @entity364 @entity8745 @entity2841
UNASSIGNED: The prompt diagnosis and treatment of @entity30106 is critical, but culture is insensitive (1, 3).-beta-D-glucan (BDG) is FDA-approved for serologic diagnosis of invasive @entity364 . However, BDG is not approved for @entity2841 and the appropriate cutoff is unknown. We aim to validate the diagnostic accuracy of @entity2841 BDG for @entity30106 among @entity1 exposed to contaminated @entity8745 (MPA). A retrospective observational study was conducted at St. Joseph Mercy Hospital and Vanderbilt University from November, 2013 - February, 2014. @entity1 were included if they received a contaminated MPA injection. Cases were classified as probable or proven @entity693 according to Centers for Disease Control and Prevention guidelines. @entity2841 BDG testing was performed according to the package insert for serum and validated using Clinical Laboratory Standards Institute procedures (MiraVista Diagnostics). Of 233 @entity1 , 45 had @entity693 (28 proven), 53 had spinal/paraspinal infection (19 proven), and 135 did not develop disease. Using the manufacturer's cutoff (>=  80 pg/mL), the sensitivity and specificity were 96% and 95% for proven @entity693 ; and 84% and 95% for probable or proven @entity693 . The Receiver Operating Characteristic analysis identified the optimal cutoff for proven @entity693 to be 66 pg/mL (sensitivity 100%, specificity 94%); for probable or proven @entity693 to be 66 pg/mL (sensitivity 91%, specificity 92%). Our results suggest that @entity2841 BDG is highly sensitive and specific for diagnosis of @entity30106 associated with contaminated MPA injections. Further study is needed on the utility of @entity2841 BDG for other types of @entity30106 .
