title: Detection of fungal DNA in peritoneal fluids by a PCR DNA low-density microarray system and quantitation of serum (1-3)-β-D-glucan in the diagnosis of peritoneal candidiasis.
abstract: Microbiological documentation of peritoneal candidiasis (PC) is hampered by the low numbers of yeasts observable by direct microscopic examination and recoverable by culture methods. The performance of a polymerase chain reaction (PCR) DNA Low-Density Microarray System (CLART STIs B) was compared to that of BACTEC FX automated culture method for the detection of Candida spp. in 161 peritoneal fluids (PF) from patients with peritonitis. The clinical utility of (1-3)-β-d-glucan (BDG) antigenemia in the diagnosis of PC was evaluated in 42 of these patients. The overall agreement between the PCR assay and the culture method was good (κ = 0.790), and their sensitivities were 93.5% and 74.19%, respectively. Serum BDG levels in patients with Candida spp. in PFs (median, 200.3 pg/mL; Range, 22.0-523.4 pg/mL) was significantly higher (P = 0.002) than those found in patients without the yeast (median, 25.3 pg/mL; Range, 0-523.4 pg/mL). Our study demonstrates the potential clinical utility of molecular methods and the measurement of serum BDG levels for the diagnosis of PC.
authors.affiliation: Microbiology Service, University Clinic Hospital, Institute of Research INCLIVA, Valencia, Spain.
authors.forename: Isabel
authors.initials: I
authors.lastname: Corrales
authors.affiliation: Microbiology Service, University Clinic Hospital, Institute of Research INCLIVA, Valencia, Spain.
authors.forename: Estela
authors.initials: E
authors.lastname: Giménez
authors.affiliation: Surgical Intensive Care Unit, University Clinic Hospital, Institute of Research INCLIVA, Valencia, Spain.
authors.forename: Gerardo
authors.initials: G
authors.lastname: Aguilar
authors.affiliation: Surgical Intensive Care Unit, University Clinic Hospital, Institute of Research INCLIVA, Valencia, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Delgado
authors.affiliation: Surgical Intensive Care Unit, University Clinic Hospital, Institute of Research INCLIVA, Valencia, Spain.
authors.forename: Jaime
authors.initials: J
authors.lastname: Puig
authors.affiliation: Surgical Intensive Care Unit, University Clinic Hospital, Institute of Research INCLIVA, Valencia, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Izquierdo
authors.affiliation: Surgical Intensive Care Unit, University Clinic Hospital, Institute of Research INCLIVA, Valencia, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Belda
authors.affiliation: Microbiology Service, University Clinic Hospital, Institute of Research INCLIVA, Valencia, Spain david.navarro@uv.es.
authors.forename: David
authors.initials: D
authors.lastname: Navarro
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001202:Ascitic Fluid / Q000382:microbiology*; D002177:Candidiasis / Q000175:diagnosis*; D004271:DNA, Fungal / Q000032:analysis* / Q000235:genetics; D005260:Female; D006801:Humans; D008297:Male; D046228:Microarray Analysis / Q000379:methods*; D008875:Middle Aged; D010529:Peritoneal Cavity / Q000382:microbiology; D010538:Peritonitis / Q000175:diagnosis* / Q000382:microbiology; D016133:Polymerase Chain Reaction / Q000379:methods; D011509:Proteoglycans; D012680:Sensitivity and Specificity; D044967:Serum / Q000737:chemistry*; D055815:Young Adult; D047071:beta-Glucans / Q000097:blood*
chemical_list: D004271:DNA, Fungal; D011509:Proteoglycans; D047071:beta-Glucans; C010770:polysaccharide-K
keywords: Antifungal therapy; BACTEC culture; PCR array assay; peritoneal candidiasis; peritoneal fluid; serum (1–3)-β-D-glucan