D-arabinitol versus mannan antigen and candidal protein antigen as a serum marker for Candida pyelonephritis.
To evaluate serum markers for the diagnosis of Candida pyelonephritis, levels of D-arabinitol, candidal mannan antigen and candidal protein antigen were measured using an enzymatic fluorometric assay, an enzyme immunoassay and a latex agglutination assay, respectively. The study group comprised 36 patients with candiduria (11 disseminated candidiasis, 9 Candida pyelonephritis and 16 colonization) and 27 without candiduria. The D-arabinitol/creatinine ratio was the only marker that differentiated between Candida pyelonephritis and colonization (p < 0.01). Using the cut-off values (1.4 mumol/mg of D-arabinitol/creatinine ratio, 0.28 of mannan/creatinine ratio (x 10(4)) and 1:4 of protein antigen titer) D-arabinitol/creatinine ratio showed the highest sensitivity in Candida pyelonephritis (77.8%) as compared to mannan/creatinine ratio (55.6%) and protein antigen titer (11.1%) although there were no differences in specificity, positive predictive value or negative predictive value. These results suggest that D-arabinitol/creatinine ratio is the most useful marker of Candida pyelonephritis.
Tokunaga
S
S
Department of Urology, School of Medicine, Kanazawa University, Japan.
Ohkawa
M
M
Takashima
M
M
Seto
C
C
Nakamura
S
S
D000368:Aged; D000946:Antigens, Fungal / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D002175:Candida / Q000276:immunology / Q000302:isolation & purification*; D002177:Candidiasis / Q000097:blood / Q000175:diagnosis* / Q000382:microbiology; D016022:Case-Control Studies; D005260:Female; D005656:Fungal Proteins / Q000097:blood; D006801:Humans; D008297:Male; D008351:Mannans / Q000097:blood; D008875:Middle Aged; D011237:Predictive Value of Tests; D011704:Pyelonephritis / Q000097:blood / Q000175:diagnosis* / Q000382:microbiology; D013402:Sugar Alcohols / Q000097:blood*
D000946:Antigens, Fungal; D015415:Biomarkers; D005656:Fungal Proteins; D008351:Mannans; D013402:Sugar Alcohols; C014999:arabitol