An Evaluation of Serodiagnostic Tests in Patients with Candidemia: Beta‐Glucan, Mannan, Candida Antigen by Cand‐Tec and D‐Arabinitol

Microbiology and Immunology - Tập 37 Số 3 - Trang 207-212 - 1993
Shigeru Kohno1, Kotaro Mitsutake1, Shigefumi Maesaki1, Akira Yasuoka1, Takashige Miyazaki1, Mitsuo Kaku1, Hironobu Koga1, Kohei Hara1
1The Second Department of Internal Medicine, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki, Nagasaki, 852 Japan

Tóm tắt

AbstractThe serodiagnostic tests, beta‐glucan, mannan, candida antigen by Cand‐Tec, and D‐arabinitol were evaluated in 10 patients with candidemia, 14 patients with suspected fungemia, and 10 healthy persons. By blood culture or lysis centrifugation, C. albicans was isolated from 5 patients, C. parapsilosis from 4, and C. tropicalis from 1 patient; no organisms were isolated from the 14 patients with suspected fungemia or the 10 healthy subjects. Beta‐glucan was measured by the difference between two chromogenic limulus tests (Endotoxin test‐D® and Endospecy®), which was more than 60 pg/ml in 7 of 9 (78%) candidemic patients and 1 of 12 (8%) patients with suspected fungemia. Mannan was positive in 6 of 10 (60%) candidemic patients and 1 of 13 (8%) patients with suspected fungemia. Both antigens were very sensitive and highly specific for candidemia. However, the Cand‐Tec assay was less specific, because titers of more than 4 were observed in 5 of 14 (34%) patients with suspected fungemia. D‐Arabinitol was the least sensitive, because a D‐arabinitol/creatinine ratio greater than 2.0 μmol/mg was observed in only 2 of 7 (29%) candidemic patients. The titers of serodiagnostic tests decreased after successful treatment with an anti‐fungal agent. Our results show that the combined use of the assays in necessary for accurate serological diagnosis of candidemia.

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Microbiology and Immunology

Tập 37 Số 3

207-212

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