ARTICLE Prospective study in critically ill non-neutropenic patients: diagnostic potential of (1,3)-β-D-glucan assay and circulating galactomannan for the diagnosis of invasive fungal disease J. Acosta & M. Catalan & A. del Palacio-Pérez-Medel & J.-C. Montejo & J. De-La-Cruz-Bértolo & M.-D. Moragues & J. Pontón & M. A. Finkelman & A. del Palacio Received: 12 April 2011 /Accepted: 14 July 2011 # Springer-Verlag 2011 Abstract Diagnosis of invasive fungal disease (IFD) in patients under intensive care is challenging. Circulating biomarkers, (1,3)-β-D-glucan (BG) and galactomannan (GM), were prospectively assessed in 98 critically ill patients at risk of IFD. There were 11 cases of invasive aspergillosis (IA; 4 proven and 7 probable), 9 cases of proven invasive candidiasis (IC), 1 case of mixed proven IC and probable IA, 1 case of proven zygomycosis, and 1 case of mixed mycelial proven IFD. In all IA cases there was no significant difference when the area under the receiver operating characteristic curve (AUC) of GM (0.873 [95% CI, 0.75–0.99]) and BG (0.856 [95% CI, 0.71–0.99]) were compared (p =0.871). The AUC for BG in IC and for the rest of the IFD cases was 0.605 (95% CI, 0.39–0.82) and 0.768 (95% CI, 0.63–0.90) respectively. Positive BG (40%) predated blood culture (n =3) and abdominal pus (n =1) a mean of 3.25 days before Candida was grown. In patients with IFD caused by molds, BG appeared a mean of 5.65 days before culture results. For the diagnosis of patients at risk of IC, BG has shown a high NPV (94.5%), with positive results also predating blood cultures in 30% of patients. In conclusion, early BG results permit a Electronic supplementary material The online version of this article (doi:10.1007/s10096-011-1365-0) contains supplementary material, which is available to authorized users This work is dedicated to the memory of Jose Ponton who passed away on 21 July 2010 J. Acosta : A. del Palacio (*) Department of Medical Microbiology, Hospital Universitario 12 de Octubre, Avenida de Córdoba s/n, Madrid 28041, Spain e-mail: amaliadelpalacio@gmail.com M. Catalan : J.-C. Montejo Medical Intensive Care Unit, Hospital Universitario 12 de Octubre, Avenida de Córdoba s/n, Madrid 28041, Spain A. del Palacio-Pérez-Medel Department of Internal Medicine, Hospital Universitario 12 de Octubre, Avenida de Córdoba s/n, Madrid 28041, Spain J. De-La-Cruz-Bértolo Clinical Epidemiology Unit, Hospital Universitario 12 de Octubre, Biomedical Research Institute (imas12), Avenida de Córdoba s/n, Madrid 28041, Spain M.-D. Moragues Department of Nursing, Universidad del País Vasco, Campus Universitario, Leioa 48940, Spain J. Pontón Department of Immunology, Microbiology, and Parasitology, School of Medicine and Dentistry, Universidad del País Vasco, Campus Universitario, Leioa 48940, Spain M. A. Finkelman Falmouth Technology Park, Associates of Cape Cod, Inc., East Falmouth, Massachusetts, 124 Bernard E. Saint Jean Drive, East Falmouth, MA 02536-4445, USA Eur J Clin Microbiol Infect Dis DOI 10.1007/s10096-011-1365-0