title: Urine D-arabinitol/L-arabinitol ratio in diagnosing Candida infection in patients with haematological malignancy and HIV infection.
abstract: Adult patients with hematologic malignancies along with HIV infected patients were prospectively studied to determine the performance of urine D-arabinitol/L-arabinitol (DA/LA) ratio in diagnosing invasive candidiasis. Ten evaluable febrile neutropenic patients had proven invasive candidiasis and elevated DA/LA ratios were found in 5. Invasive candidiasis with normal DA/LA ratios was most frequently due to Candida krusei infection. This Candida species is a non-producer of arabinitol. Only 4 of 81 febrile neutropenic patients given either antifungal prophylaxis or empiric antifungal treatment had elevated DA/LA ratios. Only 1 of 15 HIV positive patients with either oropharyngeal or esophageal candidiasis had elevated DA/LA ratios. Widespread use of fluconazole prophylaxis in bone marrow transplantation patients at the study hospital has led to an increased prevalence of C. krusei infection. This is the likely reason for the low sensitivity of the test in proven and suspected invasive Candida infections reported here.
authors.affiliation: Infectious Diseases Unit, Royal Brisbane Hospital, Herston Road, 4029, Herston, Queensland, Australia. damon_eisen@health.qld.gov.au
authors.forename: Damon P
authors.initials: DP
authors.lastname: Eisen
authors.forename: Paul B
authors.initials: PB
authors.lastname: Bartley
authors.forename: William
authors.initials: W
authors.lastname: Hope
authors.forename: Gudrun
authors.initials: G
authors.lastname: Sigmundsdottir
authors.forename: Christina
authors.initials: C
authors.lastname: Pehrson
authors.forename: Lennart
authors.initials: L
authors.lastname: Larsson
authors.forename: Bertil
authors.initials: B
authors.lastname: Christensson
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy / Q000652:urine*; D000328:Adult; D002175:Candida; D002177:Candidiasis / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy / Q000652:urine*; D006405:Hematology; D006801:Humans; D011446:Prospective Studies; D013402:Sugar Alcohols / Q000652:urine*
chemical_list: D013402:Sugar Alcohols; C014999:arabitol