Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Herzeg, A.
Influence of open and laparoscopic abdominal surgery involving the intestinal tract on serum 1,3-ß-D-glucan (BDG) values
Humanmedizin; [ Diplomarbeit ] ; 2019. pp. 58
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Krause Robert
- Zurl Christoph Johann
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- Abstract:
- Background: Invasive Candida infections occur within immunocompromised patients and patients treated in intensive care units. Furthermore, invasive candidiasis is the most common serious fungal infection in amongst these patients. 1,3-β-D-Glucan, a major cell wall component of many fungi, is used as biomarker for invasive fungal diseases. Nevertheless, other glucans, such as cellulose, can interfere with 1,3-β-D-glucan testing and lead to false positive results. Furthermore, Candida spp., of which 1,3-β-D-glucan is a cell wall component, are part of the commensal flora of the human body. The aim of this study is to evaluate the influence of open and laparoscopic abdominal surgery on peri- and post-operative 1,3-β-D-glucan values. Hypothesis: Candida spp. are occurring in the normal, commensal gut flora. Moreover, we are eating 1,3-β-D-Glucan within our food. Therefore, we are expecting that abdominal surgery, due to cutting/dividing the colon and/or rectum, is leading to elevated 1,3-β-D-glucan values in laparoscopic and open abdominal surgery. Moreover, several procedures known to cause elevated 1,3-β-D-glucan are applied during routine abdominal surgery. Methods: Of 50 patients included in the study, 24 underwent laparoscopic surgery and 26 open abdominal surgery. We took of each patient 7 blood samples at scheduled times. By using the Fungitell© assay we tested from these samples the 1,3-β-D-glucan values. As proposed by the manufacturer a value of ≥80pg/ml is assumed to be positive and a value of < 60pg/ml to be negative. Results: We could show that 1,3-β-D-Glucan values significantly rose during and after open and laparoscopic abdominal surgery. In 54% to 61% of the patients we retrieved a positive 1,3-β-D-glucan value of ≥80pg/ml during the operation. Moreover, we could show that 1,3-β-D-glucan values increase more in open abdominal surgery than in laparoscopic. Conclusion: 1,3-β-D-Glucan values significantly rise during and after abdominal surgery. This elevation can be observed several days after the operation. Therefore the value of a positive 1,3-β-D-glucan test in a perioperative setting seems to be limited up to 5 days due to 1,3-β-D-glucan elevations by surgical procedures. As the exact reasons for the elevations of 1,3-β-D-glucan remain unclear, further studies will be needed.