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A Retrospective Cross-Sectional Study Investigating the Effect of Albumin Administration on the BDG (1,3-β-D-glucan)
Chelsea Huerter1, Emily Hughes1, Monica Ahrens2
1The University of Kansas School of Medicine-Wichita, Wichita, Kansas.
Introduction:
The β-D-glucan (BDG) serum assay is a screening tool used in the diagnosis and management of invasive fungal infections (IFI). False-positive results have been reported, including in patients who have recently received intravenous albumin prior to testing. Author of this study examined the association between timing of albumin administration and BDG assay results.
Methods:
We conducted a retrospective cross-sectional study of 4,599 electronic health records at The University of Kansas Health System (TUKHS). Patients were eligible if they were ≥18 years of age and had a BDG serum assay performed between 2010 and 2020. Demographic data, comorbidities, albumin administration, and IFI status were extracted and recorded in REDCap, a HIPAA-compliant database. The final analytic cohort included 2,061 patients. Logistic regression was used to assess the association between time from albumin administration to BDG testing and false-positive results. Statistical analyses were performed using R version 4.5.2.
Results:
A total of 255 patients received albumin within two weeks prior to BDG testing, of whom 109 (42.7%) had a positive BDG result. Among these positive results, 83 were classified as false positives (false-positive rate: 76.1%). Logistic regression demonstrated the highest odds of a false-positive result when albumin was administered 6-8 days prior to testing (OR 1.22; 95% CI 0.51-2.91).
Conclusions:
Albumin administration within days preceding BDG testing may be associated with an increased risk of false-positive results, potentially leading to unnecessary diagnostic evaluation and treatment.
Insights
Intravenous albumin administration shortly before β-D-glucan (BDG) testing may increase false-positive results for invasive fungal infections (IFI). This association highlights the need to consider albumin timing to avoid misdiagnosis and unnecessary treatment.
Area of Science:
- Medical Diagnostics
- Clinical Microbiology
- Infectious Diseases
Background:
- The β-D-glucan (BDG) serum assay is crucial for diagnosing invasive fungal infections (IFI).
- False-positive BDG results have been linked to recent intravenous albumin administration.
- The impact of albumin administration timing on BDG assay accuracy requires investigation.
Purpose of the Study:
- To examine the association between the timing of albumin administration and BDG assay results.
- To determine if recent albumin administration influences the likelihood of false-positive BDG tests.
Main Methods:
- A retrospective cross-sectional study analyzed 2,061 patient records from The University of Kansas Health System (2010-2020).
- Data included demographics, comorbidities, albumin administration, and IFI status.
- Logistic regression assessed the relationship between time from albumin to BDG testing and false-positive results.
Main Results:
- Of 255 patients receiving albumin within two weeks of BDG testing, 109 (42.7%) had positive BDG results.
- A false-positive rate of 76.1% (83 of 109) was observed among these positive results.
- Albumin administered 6-8 days prior to testing showed the highest odds of a false-positive result (OR 1.22).
Conclusions:
- Albumin administration in the days preceding BDG testing may be associated with an increased risk of false-positive results.
- This association could lead to unnecessary diagnostic workups and treatments for invasive fungal infections.
- Clinical interpretation of BDG assays should consider recent albumin administration history.
