title: Characteristic and clinical relevance of Candida mannan test in the diagnosis of probable invasive candidiasis.
abstract: The gold standard laboratory tests used to diagnose invasive Candida infection (ICI) are based on the in vitro culture of blood or samples from other sterile sites. However, these tests have limited sensitivity (Se) and are generally not diagnostic until late in the infectious process. The Serion Candida mannan kit was evaluated for the diagnosis of ICI at Grenoble University Hospital (France) between 2007 and 2011. The results were then compared with worldwide data published between 1997 and 2011. This retrospective study was based on follow-up from the investigation of 162 patients of whom 91 had proven ICI; 13 had Candida colonization index (CCI) scores ≥0.42, positive mannan tests, with nonconcomitant infections; and 58 had no evidence of Candida infection. Candida albicans, C. glabrata, C. tropicalis, and C. parapsilosis were the etiologic agents in 104 patients. For patients with or without ICI, the 12-week mortality rates were 35/104 (33.7%) and 6/58 (10.3%), respectively. The mannan diagnostic specificity was 51% and Se was 77%. However, in the meta-analysis (n = 1,536), values were 86% and 62%, respectively. Positive mannan test results may appear early (median 6 days) in the development of candidemia and have moderate diagnostic value for ICI, with a negative predictive value of 83%. In patients at risk of ICI with negative candidemia, the combination of Candida mannan test data with a CCI score ≥0.42 may improve the diagnosis of probable ICI.
authors.affiliation: Laboratory of Parasitology and Mycology, Grenoble University Hospital, Joseph Fourier University, Grenoble, France BChumpitazi@chu-grenoble.fr.
authors.forename: Bernabé F F
authors.initials: BF
authors.lastname: Chumpitazi
authors.affiliation: Laboratory of Parasitology and Mycology, Grenoble University Hospital, Joseph Fourier University, Grenoble, France.
authors.forename: Bernadette
authors.initials: B
authors.lastname: Lebeau
authors.affiliation: Laboratory of Parasitology and Mycology, Grenoble University Hospital, Joseph Fourier University, Grenoble, France.
authors.forename: Odile
authors.initials: O
authors.lastname: Faure-Cognet
authors.affiliation: Clinic of Medical Intensive Care, Grenoble University Hospital, Joseph Fourier University, Grenoble, France.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Hamidfar-Roy
authors.affiliation: Clinic of Medical Intensive Care, Grenoble University Hospital, Joseph Fourier University, Grenoble, France.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Timsit
authors.affiliation: Department of Infectious and Tropical Diseases, Grenoble University Hospital, Joseph Fourier University, Grenoble, France.
authors.forename: Patricia
authors.initials: P
authors.lastname: Pavese
authors.affiliation: Department of Hematology, Grenoble University Hospital, Joseph Fourier University, Grenoble, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Thiebaut-Bertrand
authors.affiliation: Center of Clinic Investigation, Grenoble University Hospital, Joseph Fourier University, Grenoble, France.
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Quesada
authors.affiliation: Laboratory of Parasitology and Mycology, Grenoble University Hospital, Joseph Fourier University, Grenoble, France.
authors.forename: Hervé
authors.initials: H
authors.lastname: Pelloux
authors.affiliation: Laboratory of Parasitology and Mycology, Grenoble University Hospital, Joseph Fourier University, Grenoble, France.
authors.forename: Claudine
authors.initials: C
authors.lastname: Pinel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000908:Antibodies, Fungal / Q000097:blood*; D000946:Antigens, Fungal / Q000276:immunology*; D002175:Candida / Q000276:immunology* / Q000302:isolation & purification; D058365:Candidiasis, Invasive / Q000175:diagnosis* / Q000382:microbiology / Q000401:mortality; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008351:Mannans / Q000097:blood*; D008875:Middle Aged; D012372:ROC Curve; D011933:Reagent Kits, Diagnostic; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000908:Antibodies, Fungal; D000946:Antigens, Fungal; D008351:Mannans; D011933:Reagent Kits, Diagnostic
keywords: candidemia; invasive Candida infection; mannan; systematic review