[Experience with the Platelia Candida ELISA for the diagnostics of invasive candidosis in neutropenic patients].
Invasive Candida infections (IC) belong to the most important opportunistic fungal infections in immunocompromised patients. IC is difficult to diagnose, because clinical symptoms are nonspecific and cultural methods lack sensitivity or specificity. We evaluated the Platelia Candida enzyme immunoassay (Candida EIA) for the diagnosis of IC in patients with haematological malignancies. A total of 62 neutropenic patients with 469 serum samples were included in the study. Candida colonization was monitored by weekly cultures of mouth washings, urine, and stool samples. Yeasts were grown from samples of 42 patients (68%), mainly Candida albicans (50%), followed by Candida glabrata (23%) and Candida krusei (20%). According to the criteria of the EORTC/NIH, the patients were categorized: (1) 3 patients with proven IC; (2) 6 patients with probable IC; (3) 34 patients colonized with Candida; (4) 19 patients without Candida colonization and without IC. In the patient categories (1) to (4), 3/3 (100%), 3/6 (50%), 20/34 (59%), and 7/19 (37%) patients were Candida EIA positive (>0.5 ng/ml) in at least one serum sample. The sensitivity of the assay for the detection of proven IC was 100%, for proven and probable IC 67%, the specificity was 49% for both groups. An increase of the cut-off value to 2.0 ng/ml raised the specificity to 61%, but lowered the sensitivity to 56%. In conclusion, the Platelia Candida EIA does not discriminate between Candida colonization and probable invasive infection in haematological patients.
Rimek
D
D
Abteilung für Medizinische Mikrobiologie und Krankenhaushygiene, Universität Rostock, D-18059 Rostock, Germany. drimek@tllv.thueringen.de
Redetzke
K
K
Steiner
B
B
Podbielski
A
A
D000946:Antigens, Fungal / Q000097:blood*; D002175:Candida / Q000276:immunology*; D002177:Candidiasis / Q000175:diagnosis* / Q000276:immunology; D005243:Feces / Q000382:microbiology; D019337:Hematologic Neoplasms / Q000150:complications*; D006801:Humans; D016867:Immunocompromised Host; D007124:Immunoenzyme Techniques / Q000379:methods*; D008351:Mannans / Q000276:immunology; D009055:Mouth / Q000382:microbiology; D009503:Neutropenia / Q000150:complications*; D012680:Sensitivity and Specificity; D014556:Urine / Q000382:microbiology
D000946:Antigens, Fungal; D008351:Mannans