The utility of serology in diagnosing candidosis in non-neutropenic critically ill patients.
This study was carried out to evaluate the utility of serological tests in the diagnosis of candidal infections in non-neutropenic critically ill patients. A prospective study was carried out in a 10-bed general intensive care unit; all patients with at least one organic sample with Candida spp. were included. A therapeutic-diagnostic algorithm was designed, and patients were treated or not, according to a classification. Blood samples were taken, and serological tests included: antigenaemia detection using two different commercial latex kits (Cand-Tec and Pastorex) and antibody detection by indirect haemagglutination (IHA) and indirect germ tube immunofluorescence (IFA). A total of 56% of antibody tests (IHA 45% and IFA 64%) and 26% of antigen tests (Cand-Tec 36% and Pastorex 17%) were positive. The sensitivity and specificity of these tests with respect to systemic candidosis were 37% and 78%, respectively, for antibodies, and 0% and 90% for antigens. There was statistical significance for mortality and low levels of antibodies; Candida glabrata was detected by IFA and Candida tropicalis by Cand-Tec. Serological tests may help to define the prognosis of these patients and to support the detection of specific Candida species.
Ibàñez-Nolla
J
J
Intensive Care Unit, Hospital General de Catalunya, C/Gomera s/n, Sant Cugat del Vallès, Barcelona, 08190 Spain. medicinaintensiva@hgc.es
Torres-Rodríguez
J M
JM
Nolla
M
M
León
M A
MA
Mèndez
R
R
Soria
G
G
Díaz
R M
RM
Marrugat
J
J
D000908:Antibodies, Fungal / Q000097:blood; D000946:Antigens, Fungal / Q000032:analysis; D002175:Candida / Q000276:immunology* / Q000302:isolation & purification; D002177:Candidiasis / Q000175:diagnosis* / Q000382:microbiology; D006801:Humans; D007362:Intensive Care Units; D009503:Neutropenia; D011446:Prospective Studies; D012698:Serologic Tests / Q000379:methods*
D000908:Antibodies, Fungal; D000946:Antigens, Fungal