Serum mannan and galactomannan level in culture-negative sepsis patients having suspected invasive fungal infections during COVID-19 pandemic: A clinico-microbiological study

Objectives Management of culture-negative sepsis in intensive care unit (ICU) admitted patients is difficult as these events are infectious and non-infectious in etiology. Thus, in the era of modern medicine, serological tests might help clinicians for better management of culture-negative sepsis events in ICU-admitted patients. Materials and Methods We prospectively enrolled 100 patients having culture-negative sepsis, admitted to the ICU during the COVID-19 pandemic. Baseline serum mannan and galactomannan (GM) levels by enzyme-linked immunosorbent assay-based method were determined in each patient. Concomitantly, C-reactive protein (CRP) and procalcitonin (PCT) values were also determined and the results were compared with other clinicoradiological evidence. Statistical analysis We determined the correlation between serum mannan and PCT, serum GM, and PCT by Spearman correlation coefficient. Results Baseline serum GM, mannan, PCT, and CRP were determined in 100 patients having culture-negative sepsis. A significantly higher mannan (125 pg/mL) was determined in 16 patients, whereas GM antigen (GM index [GMI] >0.5) was positive in 47 enrolled patients. 45 enrolled patients with higher GMI (>0.5) had respiratory symptoms. Out of 16 patients having higher mannan levels, only 3 had higher GMI. We also observed a significant negative correlation between serum mannan and PCT; a negative correlation between GMI and PCT; and a positive correlation between acute physiology and chronic health evaluation II score and PCT. Conclusions Composite tests alike serum mannan, GM, PCT, and CRP might be helpful in the management of culture-negative sepsis events in ICU-admitted patients.