Value of Candida antigen and antibody assays for the diagnosis of invasive candidosis in surgical intensive care patients.
During a 3-year period, a clinical diagnosis of invasive candidosis was made in 8 out of 2054 consecutive surgical intensive care unit (ICU) patients. These patients were retrospectively matched with 16 control patients who underwent similar surgical procedures and had a similar clinical course except for negative Candida cultures. In all patients, Candida antigen (Ramco CandTec serum antigen test) and antibody serology (Candida HA test) were determined at least once a week during their stay. The antigen test was positive in 1/8 patients and 4/16 controls and thus did not differentiate patients with candidosis from non-infected controls. The HA antibody titer results fulfilled the manufacturer's criteria for positivity in 7/8 patients with candidosis and 2/16 control patients. Thus, the Candida HA antibody test, but not the Ramco antigen test, can be recommended to confirm a clinical diagnosis of invasive candidosis.
Lepper
P M
PM
Department of Medical Microbiology and Hygiene, Ulm University Hospital, Germany.
Wiedeck
H
H
Geldner
G
G
Essig
A
A
Trautmann
M
M
D018806:APACHE; D000908:Antibodies, Fungal / Q000097:blood; D000946:Antigens, Fungal / Q000097:blood; D002176:Candida albicans / Q000276:immunology* / Q000302:isolation & purification; D002177:Candidiasis / Q000175:diagnosis* / Q000453:epidemiology; D003422:Critical Care; D005260:Female; D016469:Fungemia / Q000175:diagnosis* / Q000453:epidemiology; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D011184:Postoperative Period; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
D000908:Antibodies, Fungal; D000946:Antigens, Fungal