Diagnosis of systemicCandidainfections in patients of the intensive care unit. Significance of serum antigens and antibodies

Abstract

The combined detection of Candida antigen and antibody for the determination of systemic Candida infections (SCI) was investigated. One hundred and four patients from the intensive care unit (ICU) were analysed. Seventeen of the patients were suspected of having SCI, based on clinical and laboratory criteria. In these patients, Candida antigens and antibodies were analysed extensively. Ten patients had a positive Candida antigen (titre >1:16) determined by the latex agglutination assay Cand-Tec(R) and their median antibody titre was 1:160 in the indirect haemagglutination test (HAT). Seven antigen-negative patients had a median titre of 1:1280 (HAT). Forty-one of 42 colonized control patients had negative antigen titres and a median antibody titre of 1:160. The sensitivities and specificities were 58.8% and 97.6% for antigenemia, and 52.9% and 85.7% for antibody detection. These values reached 100.0% and 83.3%, respectively, when the results of both tests were combined. This indicates a high degree of concordance between serological results (Candida antigen and/or antibodies) and clinical presentation. We conclude, that the combined investigation of antigen and antibody titres might be a helpful tool in the characterization of SCI in ICU patients, if antigen titres are >or=1:16 or antibody titres (HAT) are >or=1:640.

Production of hybrid phage displaying secreted aspartyl proteinase epitope of Candida albicans and its application for the diagnosis of disseminated candidiasis

“…The laboratory diagnosis of candidaemia is presently based on direct examination and conventional blood culture with a sensitivity of only 40%. 2 Microbiological evidence for the diagnosis of invasive candidiasis requires multiple consecutive blood cultures. The current phage-ELISA demonstrated that 77% of mice with systemic C. albicans infection produced 1 The specimens were obtained from mice (n ¼ 30) infected intravenously with 10 6 C. albicans strain ATCC 10231.…”

“…The current phage-ELISA demonstrated that 77% of mice with systemic C. albicans infection produced 1 The specimens were obtained from mice (n ¼ 30) infected intravenously with 10 6 C. albicans strain ATCC 10231. 2 Using 50 ll of blood collected. 3 Positive results were determined according to Table 1: OD of serum ‡0.159 (mean OD + 2 SD of non-infected control group).…”

“…Mice were infected intravenously with 10 6 C. albicans ATCC 10231 and sera were collected on week 3 after infection. 2 Mice were immunosuppressed with cortisone acetate, and sera were collected on week 3 after oropharyngeal inoculation by 10 8 C. albicans yeast cells.…”

“…Blood or urine cultures are often negative or become positive only after a long delay. 2 Therefore, the clinician must often make an empiric therapeutic decision; consequently, many patients are overtreated with unnecessary highly nephrotoxic agents. Clearly, a sensitive and rapid method for early diagnosis of systemic C. albicans infection is needed.…”

Expression of interleukin‐8 and its receptor IL‐8RA in chronic hyperplastic candidosis

“…those with diabetes mellitus and those undergoing immunosuppressive therapy, fungi can cause a variety of opportunistic infections (11). Candida species, in particular, are implicated in nosocomial infections (4, 22). Therefore, fungal infections are sometimes referred to as ‘diseases of the diseased’ (26).…”