Determination of serum arabinitol levels by mass spectrometry in patients with postoperative candidiasis.
A combined gas chromatography-mass spectrometry (GC-MS) technique was used for serial determination of serum arabinitol levels in patients with postoperative candidiasis. Forty subjects were investigated, 18 patients with candidiasis, 7 patients with superficial Candida colonization and 15 postoperative control patients. The arabinitol levels were highly elevated, slightly elevated and normal in 13, 1 and 4 patients respectively with candidiasis; in 2, 2 and 3 colonized patients and in 1, 1 and 13 control patients (p < 0.001, chi 2, between all the groups). The sensitivity of a single arabinitol determination for detection of postoperative candidiasis was 27.6 % and the specificity 89.2 %. Use of multiple samples improved sensitivity up to 72.2% per patient (123 samples) with a specificity of 86.4 %. Highly elevated arabinitol concentrations were detected in only one patient before the onset of therapy. Determination of arabinitol levels by GC-MS is a specific test for diagnosing candidiasis, but multiple samples are required for adequate sensitivity, and the initiation of therapy must still be on an empirical basis.
Lehtonen
L
L
Department of Medical Microbiology, University of Turku, Finland.
Rantala
A
A
Oksman
P
P
Eerola
E
E
Lehtonen
O P
OP
D002177:Candidiasis / Q000097:blood* / Q000175:diagnosis; D016009:Chi-Square Distribution; D003404:Creatinine / Q000097:blood; D008401:Gas Chromatography-Mass Spectrometry / Q000379:methods*; D006801:Humans; D011183:Postoperative Complications; D012016:Reference Values; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013402:Sugar Alcohols / Q000097:blood*; D013997:Time Factors
D013402:Sugar Alcohols; D003404:Creatinine; C014999:arabitol