Detection of antibodies and antigenemia in leukemic patients with candidiasis by enzyme-linked immunosorbent assay.
Standard tests and two enzyme-linked immunosorbent assays (ELISAs) were compared for detecting systemic candidiasis in 92 leukemic patients. Antibodies to Candida were detected by immunodiffusion (ID), latex agglutination (LA), and indirect ELISA; antigenemia was evaluated by indirect ELISA inhibition. In 48 patients without candidiasis (group 1), sera from 27% reacted in ID and 13% in LA tests; titers of antibody by ELISA occurred in all patients. In 34 patients without disseminated candidiasis (groups 2 and 3), Candida species were isolated; sera from 35% and 32% were positive in the ID and the LA test, respectively. In nine of 10 patients with disseminated candidiasis (group 4), LA and ID tests were negative. Seven patients in groups 1-3 without disseminated candidiasis were antigenemic (false-positive rate, 9%). Antigenemia was detected in seven of 10 patients with disseminated candidiasis; in the remaining three patients sera were drawn too early to be of diagnostic value. Thus, monitoring of immunosuppressed patients for mannan antigenemia is useful for the detection of disseminated candidiasis.
D000328:Adult; D000368:Aged; D000908:Antibodies, Fungal / Q000032:analysis*; D000946:Antigens, Fungal / Q000032:analysis*; D002176:Candida albicans / Q000276:immunology*; D002177:Candidiasis / Q000150:complications* / Q000276:immunology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007938:Leukemia / Q000150:complications*; D007951:Leukemia, Myeloid / Q000150:complications; D008297:Male; D008351:Mannans / Q000032:analysis; D008875:Middle Aged
D000908:Antibodies, Fungal; D000946:Antigens, Fungal; D008351:Mannans