The Beta-D-glucan Test: Time to Re-Visit Its Utility in IFI Diagnosis

Invasive fungal infections (IFIs) are life-threatening complications both in hemato-oncological and intensive care unit (ICU) patients, and early diagnosis is crucial for outcome. Culture-based methods for the diagnosis of IFI have limited performance, and newer surrogate markers with improved sensitivity and specificity are needed to enable earlier diagnosis and to provide prognostic information and/or permit response monitoring. Fungal biomarkers such as galactomannan (GM) and 1,3-β-d-glucan (BDG) have been increasingly utilized in the last decade for an early and accurate diagnosis of these infections. This review will report the recent developments in the use of BDG for the diagnosis of IFI, focusing in particular on the latest clinical data on the diagnosis of invasive candidemia, invasive aspergillosis and pneumocystosis. In addition, the use of the assay in samples other than serum, as well as its limitations, will be described.