(1,3)-β-D-glucan is a major cell wall component of many fungi and its detection in serum acts as an aid in the diagnosis of invasive fungal disease when used in conjunction with other diagnostic fungal biomarkers. Early diagnosis of fungal infections is key to ensure appropriate antifungal treatment is commenced without delay.
Invasive fungal diseases are common opportunistic infections among immunosuppressed patients.
Immunosuppressed patients, particularly organ transplant recipients, patients with haematological malignancies, and those receiving immunosuppressive treatments, are at risk of invasive fungal disease.
The diagnosis of invasive fungal disease is based on clinical findings, radiological changes, and the detection of fungal biomarkers such as serum β-d glucan, galactomannan and pathogen identification by molecular, culture or serological methods.
Opportunistic fungal pathogens which produce detectable (1,3)-β-D-glucan include:
- Candida spp.
- Aspergillus spp.
- Fusarium spp.
- Trichosporon spp.
- Saccharomyces cerevisiae
- Acremonium spp.
- Coccidioides immitis
- Histoplasma capsulatum
- Sporothrix schenckii
- Exserohilum rostratum
- Pneumocystis jirovecii.
The presence of (1,3)-β-D-glucan does not differentiate between the genus of fungi detected. On occasion, false positive results have been found in situations such as patients on haemodialysis with cellulose membranes, those treated with certain fractionated blood products such as serum albumin and immunoglobulins, and in those exposed to glucan-containing gauze and surgical sponges. Serum titres off (1,3)-β-D-glucan are used in conjunction with other diagnostic fungal biomarkers including galactomannan for the identification of invasive fungal disease.
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5ml venous serum
This qualitative test is used to detect the BDG antigen, based on A protease zymogen-based colorimetric assay for the detection of BDG in the serum of patients with symptoms or medical conditions predisposing the patient to invasive fungal infection.
For clients using the Enfer Medical Client Portal, the Enfer Medical Patient Request Form (PRF) will be generated when you have completed your “Test Request” within the portal linked below.
Please note that samples suspected of containing high risk pathogens such as Mycobacterium tuberculosis should be clearly identified on the form and packed separately from other samples.
Results are available within 24 – 48 hours
This assay is available five days a week (Monday-Friday)
The packaging/preparation of samples for delivery to the laboratory is required to be in adherence to all national regulations for the safe transport of biological materials. HSE guidance can be reviewed HERE.
There are specific packaging instructions and labelling requirements requiring triple packaging including:
- Primary leak-proof container – tube or vial containing the sample.
- Secondary watertight container, with absorbent material, intended to protect the primary container.
- Outer container protects the secondary container.
- Patient Request forms must be placed between the secondary container and the outer shipping container.
Further information on the packaging/preparation of samples for delivery to the laboratory is contained within the Enfer Medical Laboratory User Manual which clients are provided with.
Storage & Stability
Specimens must be tested within 14 days of collection and stored at 2-8◦C.
In addition to the packaging of samples, the transport/delivery of clinical samples to the laboratory is required to be in adherence to all national regulations for the safe transport of biological materials. Enfer Medical provides a fully compliant logistics service, aligned with clients’ testing requirements.
Prompt transport of specimens:
To ensure prompt testing of samples and release of results within the published test turnaround times, samples should arrive to the laboratory by 18:00. Test turnaround time is measured from receipt of the sample at the laboratory until the time the authorised results are reported to users.
In rare cases specimens may not be suitable for testing on arrival to the laboratory. In that case the sample will be rejected at the receipt stage and the service user will be notified immediately and an explanation as to why the sample could not be processed will be provided. Reasons why samples cannot be processed include but are not limited to:
- Samples received beyond the stability limits and/or not at the correct temperature indicated for each test.
- Incorrect sample type received.
- Leaking samples, sample not received or sample insufficient for analysis as stated below within sample requirements.
- Non-compliant samples or request forms i.e. those missing sample date information, missing sample test request and/or missing sample site/type information.
- Samples received without the necessary patient identifiers.
- NOT DETECTED
Following receipt at the laboratory, results should be available on the next working day and will be reported to the referring clinician via the Enfer Medical Client Portal or in a format agreed with clients.
Established clients can login to the portal using the link above.