Determination of urinary D-/L-arabinitol ratios as a biomarker for invasive candidiasis in children with cardiac diseases.
A non-invasive, non-culture-based method of determining urinary D-/L-arabinitol (D-/L-ARA) ratios was investigated as a tool for the diagnosis of invasive candidiasis in nosocomial paediatric infection cases. The study encompassed 138 children aged 4 days to 16 years (mean ± SD=1.6 ± 4.2 years) with congenital heart defects (91.4%) or with rhythm disorders or circulatory failure (8.6%). ARA enantiomers were detected by GC using an electron capture detector. Positive D-/L-ARA ratios were found for 11/11 patients with proven candidiasis and 17/19 patients with clinically suspected invasive candidiasis. Thirty children were undergoing antifungal chemotherapy. D-/L-ARA ratios (mean ± SD) were 2.601 ± 0.544 in hospitalized cardiac patients without fungal infection and 5.120 ± 1.253 in those receiving antifungal therapy (P<0.001). The sensitivity of the method was 100%, the specificity 97.2%, the positive predictive value was 78.6% and the negative predictive value was 100%.
Stradomska
Teresa J
TJ
Department of Biochemistry and Experimental Medicine, Children's Memorial Health Institute, Aleja Dzieci Polskich 20, 04-730 Warsaw, Poland.
Sobielarska
Dorota
D
Department of Cardiology, Children's Memorial Health Institute, Aleja Dzieci Polskich 20, 04-730 Warsaw, Poland.
Mielniczuk
Zbigniew
Z
Department of Biochemistry and Experimental Medicine, Children's Memorial Health Institute, Aleja Dzieci Polskich 20, 04-730 Warsaw, Poland.
Jagiełłowicz
Dorota
D
Department of Cardiology, Children's Memorial Health Institute, Aleja Dzieci Polskich 20, 04-730 Warsaw, Poland.
Syczewska
Małgorzata
M
Department of Pediatric Rehabilitation, Children's Memorial Health Institute, Aleja Dzieci Polskich 20, 04-730 Warsaw, Poland.
Dzierżanowska
Danuta
D
Department of Clinical Microbiology and Immunology, Children's Memorial Health Institute, Aleja Dzieci Polskich 20, 04-730 Warsaw, Poland.
D000293:Adolescent; D017677:Age Distribution; D015415:Biomarkers; D002177:Candidiasis / Q000175:diagnosis* / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006331:Heart Diseases / Q000150:complications*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D013402:Sugar Alcohols / Q000652:urine*
D015415:Biomarkers; D013402:Sugar Alcohols; C014999:arabitol