title: Neutrophil hypochlorous acid production is impaired in multiple organ failure patients with candidaemia; reversal with antifungal agents.
abstract: OBJECTIVE
  Neutrophil-derived hypochlorous acid (PMN-HOCL) is a potent bactericidal and fungicidal agent. Neutrophils from patients with multiple organ failure (MOF) have an altered ability to inhibit Candida albicans. Conversely antifungal agents are effective in decreasing mortality in MOF patients with fungaemia. We determined the effect on the rate of production of PMN-HOCL in a series of MOF patients with C. albicans fungaemia when antifungal agents are administered.
  
  
  METHODS
  Eleven patients with MOF were recruited. Four patients had culture-positive C. albicans fungaemia (group 1) and 7 patients with MOF but without C. albicans fungaemia acted as controls (group 2). HOCL assays were performed on peripheral blood PMN obtained from group 1 and group 2 patients.
  
  
  RESULTS
  The maximum PMN-HOCL production rate for group 1 increased from 0.24 nmol/million PMN/min to 0.8 nmol/million PMN/min after treatment with antifungal agents (p < 0.01) (Mann-Whitney U test) whereas the PMN-HOCL kinetic (rate) curves for group 1 post-treatment and for group 2 were similar (student's-t-test).
  
  
  CONCLUSIONS
  These findings suggest that antifungal treatment improve PMN-HOCL production in MOF patients with C. albicans fungaemia and may improve the effectiveness in eradicating the organism.
authors.affiliation: Department of Surgery, Belfast City Hospital, Northern Ireland. magedhussien@hotmail.com
authors.forename: M
authors.initials: M
authors.lastname: Hussien
authors.forename: R J
authors.initials: RJ
authors.lastname: Delecata
authors.forename: P D
authors.initials: PD
authors.lastname: Carey
mesh_terms: D000368:Aged; D000935:Antifungal Agents / Q000627:therapeutic use*; D002176:Candida albicans / Q000187:drug effects / Q000254:growth & development; D002177:Candidiasis / Q000188:drug therapy / Q000378:metabolism* / Q000382:microbiology; D005260:Female; D006801:Humans; D006997:Hypochlorous Acid / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000188:drug therapy / Q000378:metabolism* / Q000382:microbiology; D009504:Neutrophils / Q000187:drug effects / Q000378:metabolism*; D011446:Prospective Studies
chemical_list: D000935:Antifungal Agents; D006997:Hypochlorous Acid