Related Experiment Video
Updated: Jul 8, 2026
Detection of Invasive Pulmonary Aspergillosis in Haematological Malignancy Patients by using Lateral-flow Technology
Published on: March 22, 2012
Serum Galactomannan: A Predictor of Poor Outcomes in Peritoneal Dialysis Patients With Fungal Peritonitis
Talerngsak Kanjanabuch1,2,3, Tanawin Nopsopon4, Thunvarat Saejew2
1Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Introduction:
The potential value of serum galactomannan index (GMI) in monitoring treatment response in patients with fungal peritonitis who are receiving peritoneal dialysis (PD) was assessed in the present study.
Methods:
The study included all Thailand fungal PD-related infectious complications surveillance (MycoPDICS) DATA study participants who had timely PD catheter removal and availability of both baseline and ≥2 subsequent serum GMI measurements after starting antifungal therapy (if available). Serum GMI was assessed by direct double-sandwich enzyme-linked immunosorbent assay with reference to positive and negative control samples. Comparisons of categorical variables among groups were analyzed by Fisher's exact test for categorical data and the Wilcoxon rank-sum test for continuous variables. Mortality outcomes were analyzed by survival analyses using Kaplan-Meier curves with Log-rank test.
Results:
Seventy-six (46%) of 166 participants from 21 PD centers between 2018 and 2022 were included. The median age was 58 (50-65) years, and a half of the patients (50%) had type II diabetes. Nineteen (25%) and 57 (75%) episodes were caused by yeast and mold, respectively. Death occurred in 11 (14%) patients at 3 months, and no differences were observed in demographics, laboratories, treatment characteristics, or in baseline serum GMI between those who died and those who survived. Serum GMI progressively declined over the follow-up period after the completion of treatment. Patients who died had significantly higher posttreatment serum GMI levels and were more likely to have positive GMI after treatment.
Conclusion:
Serum GMI is an excellent biomarker for risk stratification and treatment response monitoring in patients on PD with fungal peritonitis.
Insights
Serum galactomannan index (GMI) effectively monitors fungal peritonitis treatment in peritoneal dialysis (PD) patients. Higher post-treatment GMI indicates poorer outcomes, making it a valuable biomarker for risk stratification and response assessment.
Area of Science:
- Nephrology
- Infectious Diseases
- Clinical Diagnostics
Background:
- Fungal peritonitis is a serious complication in peritoneal dialysis (PD) patients.
- Monitoring treatment response in these patients is crucial for improving outcomes.
Purpose of the Study:
- To evaluate the utility of serum galactomannan index (GMI) in monitoring treatment response.
- To assess GMI's role in risk stratification for patients with fungal peritonitis undergoing PD.
Main Methods:
- Retrospective analysis of data from the MycoPDICS surveillance study.
- Serum GMI measurements (baseline and follow-up) analyzed using ELISA.
- Statistical analysis included Fisher's exact test, Wilcoxon rank-sum test, and survival analyses (Kaplan-Meier curves).
Main Results:
- Serum GMI progressively declined post-treatment in survivors.
- Patients who died had significantly higher post-treatment GMI levels.
- Positive post-treatment GMI was associated with increased mortality risk.
Conclusions:
- Serum GMI is a valuable biomarker for monitoring treatment response in PD patients with fungal peritonitis.
- GMI aids in risk stratification and assessing therapeutic effectiveness.
Related Concept Videos
01:25Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications
01:25Peritoneal Dialysis III: Nursing Management