Comparison of β-D-Glucan levels between Candida auris and other Candida species at the time of candidaemia: a retrospective study

Objectives: To compare serum β-D-glucan (BDG) levels in candidaemia with different Candida species, especially C. auris. Methods: Aga Khan University clinical laboratory database was retrospectively reviewed from January 2015 to December 2019. Blood culture positive cases with any Candida species and concomitant BDG level were included. Results: Among the 192 cases included in our study, 48 were C. albicans, 54 C. auris, eight C. glabrata, 32 C. parapsilosis, 43 C. tropicalis and seven other Candida species. The level of BDG was significantly lower in C. auris (median 62.43, interquartile range (IQR) 12.80–182.94 pg/mL) compared to C. albicans (median 266.83, IQR 66.29–523.43 pg/mL) and C. tropicalis (median 324.41, IQR 105.20–523.44 pg/mL). The sensitivity of serum BDG was significantly lower for C. auris (43.75%, 95% CI 29.5–58.8%) than C. tropicalis (79.07%, 95% CI 64.0–90.0%). Discussion: Serum BDG has lower sensitivity in patients with suspected C. auris candidaemia in our setting. Considering that C. auris has higher morbidity and mortality than other species, a more sensitive test is required.