Serum β-D-glucan of critically ill patients with suspected ventilator-associated pneumonia: Preliminary observations

Background: The purpose of this pilot study was to determine whether beta-D-glucan (BG) was associated with Candida in the lung and risk of death in patients with suspected ventilator-associated pneumonia (VAP). Methods: In a single-center observational study, we enrolled eligible adults within 24 hours of intensive care unit admission. Patients who developed suspected VAP were divided into 3 groups according to culture results. Serum BG levels and clinical outcomes were collected. Results: Fifty-seven patients were included; 26 had no growth, 19 patients grew pathogenic bacteria only, and 12 patients grew only Candida. The proportion of patients with a positive BG tended to be greater in the Candida group (66.7% vs 26.3% in bacteria group vs 50.0% in culture-negative group, P = .09). The BG-positive patients were much more likely to die by day 28 than the BG-negative patients (odds ratio, 4.2; 95% confidence limits, 1.1-15.7; P = .03). Patients with both BG positivity and Candida in their lung secretions were much more likely to die compared with patients who did not. Conclusions: beta-D-Glucan positivity in patients with a suspected VAP may be a marker for Candida in the lung and worse outcomes. Further validation of this postulate is warranted. (c) 2011 Elsevier Inc. All rights reserved.