Diagnosis of systemic Candida infections in patients of the intensive care unit. Significance of serum antigens and antibodies.
The combined detection of Candida antigen and antibody for the determination of systemic Candida infections (SCI) was investigated. One hundred and four patients from the intensive care unit (ICU) were analysed. Seventeen of the patients were suspected of having SCI, based on clinical and laboratory criteria. In these patients, Candida antigens and antibodies were analysed extensively. Ten patients had a positive Candida antigen (titre >1:16) determined by the latex agglutination assay Cand-Tec(R) and their median antibody titre was 1:160 in the indirect haemagglutination test (HAT). Seven antigen-negative patients had a median titre of 1:1280 (HAT). Forty-one of 42 colonized control patients had negative antigen titres and a median antibody titre of 1:160. The sensitivities and specificities were 58.8% and 97.6% for antigenemia, and 52.9% and 85.7% for antibody detection. These values reached 100.0% and 83.3%, respectively, when the results of both tests were combined. This indicates a high degree of concordance between serological results (Candida antigen and/or antibodies) and clinical presentation. We conclude, that the combined investigation of antigen and antibody titres might be a helpful tool in the characterization of SCI in ICU patients, if antigen titres are >or=1:16 or antibody titres (HAT) are >or=1:640.
Bär
W
W
Institute of Medical Microbiology, Carl-Thiem-Klinikum, Cottbus, Germany. baer@ctk.de
Hecker
H
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D000908:Antibodies, Fungal / Q000097:blood*; D000946:Antigens, Fungal / Q000097:blood*; D002175:Candida / Q000276:immunology* / Q000302:isolation & purification; D002177:Candidiasis / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy; D005260:Female; D005858:Germany; D006801:Humans; D007362:Intensive Care Units; D007668:Kidney / Q000382:microbiology; D008168:Lung / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012698:Serologic Tests; D013154:Spleen / Q000382:microbiology
D000908:Antibodies, Fungal; D000946:Antigens, Fungal