title: Candida colonization index in patients admitted to an ICU.
abstract: Multiple-site colonization with Candida spp. is commonly recognized as a risk factor for invasive fungal infection in critically ill patients. We carried out a study to determine the relationship between Candida colonization and invasive infection in neurological patients admitted to an ICU. At admission (T0) and every three days for two weeks, different samples (pharynx swab, tracheal secretions, stomach contents, etc.) were collected for mycological surveillance. Candida mannan antigen and Candida anti-mannan antibodies were assayed. The Colonization Index (CI) and Corrected Colonization Index were calculated for each time point. Of all patients 70% was already colonized by Candida spp. at T0 and six of them had CI ≥ 0.5. Three patients developed candidemia; they had CI ≥ 0.5 before infection. Positive values of Candida mannan antigen and anti-mannan antibodies were found only in the patients with candidemia. The sensitivity and specificity of the Candida mannan test were 66.6% and 100%, respectively, while the sensitivity and specificity of the anti-mannan antibody test were 100%. In accordance with other authors, we find the surveillance cultures are useful to monitor the Candida colonization in ICU patients. In addition, the sequential observation of anti-mannan antibodies could contribute to early diagnosis of candidiasis more than Candida mannan antigen in immunocompetent patients.
authors.affiliation: Department of Biomedical Science and Human Oncology-Hygiene Section, University of Bari "Aldo Moro", Piazza G. Cesare no. 11, 70124 Bari, Italy; E-Mails:  catiacoretti@yahoo.it  (C.C.);  montagna@igiene.uniba.it  (M.T.M.).
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Caggiano
authors.forename: Filomena
authors.initials: F
authors.lastname: Puntillo
authors.forename: Caterina
authors.initials: C
authors.lastname: Coretti
authors.forename: Mariateresa
authors.initials: M
authors.lastname: Giglio
authors.forename: Ilaria
authors.initials: I
authors.lastname: Alicino
authors.forename: Fabio
authors.initials: F
authors.lastname: Manca
authors.forename: Francesco
authors.initials: F
authors.lastname: Bruno
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Montagna
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000906:Antibodies / Q000097:blood; D000941:Antigens / Q000032:analysis; D002175:Candida / Q000276:immunology / Q000302:isolation & purification / Q000378:metabolism*; D002177:Candidiasis / Q000150:complications / Q000175:diagnosis / Q000382:microbiology*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000150:complications / Q000382:microbiology / Q000473:pathology; D012307:Risk Factors; D013997:Time Factors; D055815:Young Adult
chemical_list: D000906:Antibodies; D000941:Antigens
references.citation: Rev Iberoam Micol. 2009 Mar 31;26(1):8-14
references.pmid: 19463272
references.citation: Med Mycol. 2005 May;43(3):235-43
references.pmid: 16010850
references.citation: Ann Fr Anesth Reanim. 2001 Apr;20(4):418-20
references.pmid: 11392256
references.citation: Clin Microbiol Rev. 2007 Jan;20(1):133-63
references.pmid: 17223626
references.citation: Pediatr Crit Care Med. 2008 Jan;9(1):91-5
references.pmid: 18477920
references.citation: J Clin Microbiol. 2005 Apr;43(4):1829-35
references.pmid: 15815004
references.citation: Int J Antimicrob Agents. 2008 Nov;32 Suppl 2:S87-91
references.pmid: 19013346
references.citation: Diagn Microbiol Infect Dis. 2005 Feb;51(2):95-101
references.pmid: 15698714
references.citation: J Clin Microbiol. 2009 Oct;47(10):3170-7
references.pmid: 19710283
references.citation: Drugs. 2008;68(14):1941-62
references.pmid: 18778118
references.citation: Mycoses. 2008 Mar;51(2):123-8
references.pmid: 18254748
references.citation: Arch Intern Med. 1989 Oct;149(10):2349-53
references.pmid: 2802900
references.citation: J Med Microbiol. 2009 May;58(Pt 5):606-615
references.pmid: 19369522
references.citation: Intensive Care Med. 1997 Mar;23(3):317-25
references.pmid: 9083235
references.citation: Lancet Infect Dis. 2003 Nov;3(11):685-702
references.pmid: 14592598
references.citation: Intensive Care Med. 2005 Mar;31(3):393-400
references.pmid: 15711782
references.citation: Intensive Care Med. 2002 Dec;28(12):1708-17
references.pmid: 12447512
references.citation: J Clin Microbiol. 2003 Oct;41(10):4551-8
references.pmid: 14532181
references.citation: Scand J Infect Dis. 2008;40(2):145-53
references.pmid: 17852926
references.citation: Ann Surg. 1994 Dec;220(6):751-8
references.pmid: 7986142
references.citation: Expert Rev Mol Diagn. 2008 May;8(3):315-25
references.pmid: 18598110
references.citation: J Med Microbiol. 2002 May;51(5):433-442
references.pmid: 11990496
references.citation: Mycoses. 2000;43(5):159-63
references.pmid: 10948811
references.citation: Am Surg. 1994 Feb;60(2):107-13
references.pmid: 8304640
references.citation: Clin Infect Dis. 2010 Sep 1;51(5):e38-45
references.pmid: 20636126
references.citation: J Clin Microbiol. 2001 Sep;39(9):3254-9
references.pmid: 11526159