title: IgG1 anti-cell wall and IgG2 anti-phosphopeptidomannan antibodies in the diagnosis of invasive candidiasis and heavy Candida colonization.
abstract: We conducted a retrospective study to evaluate the usefulness of immunoglobulin G (IgG) subclasses against Candida cell wall fragments (CW) and phosphopeptidomannan (PPM) for the diagnosis of invasive candidiasis (IC). We analyzed 54 patients with IC (n = 19), Candida heavy colonization (HC; n = 16), and controls (no IC or HC, n = 19).In nonneutropenic patients (n = 47), the sensitivity and specificity values of IgG1 anti-CW and IgG2 anti-PPM in IC were 88%, 59%, and 88%, 94%, respectively. The areas under the receiver operating characteristic curves were 0.69 (0.51-0.88) and 0.901 (0.78-1.02), respectively. IgG1 mean values (arbitrary units) and 95% confidence interval were 46 (20-71), 42 (-0.38 to 84) and 20 (8.3-32) in IC, HC, and in controls, respectively, and discriminated IC but not HC from controls (P = .032, and P = .77, respectively). IgG2 mean values were 26 (9.2-42), 19 (4.4-33), and 3.2 (0.28-6.6) in IC, HC, and in controls, respectively, and discriminated both IC and HC from controls (P < .0001 and P = .035, respectively) but did not separate IC from HC (P = .2). IgG2 showed positivity as early as one day after the IC diagnosis. Antibodies were detected in only two out of a total of seven neutropenic patients.For both IC and HC patients, the diagnostic performance of IgG2 anti-PPM was better than the one of IgG1 anti-CW. In nonneutropenic patients, IgG2 anti-PPM accurately identified not only IC patients but also HC patients at high risk for IC. This marker may help clinicians in the initiation of early preemptive therapy.
authors.affiliation: Department of Infectious Diseases, Institute of Biomedicine, University of Gothenburg, Gothenburg, Sweden Sahlgrenska University Hospital, Clinical Microbiology, Gothenburg inger.mattsby-baltzer@microbio.gu.se.
authors.forename: Inger
authors.initials: I
authors.lastname: Mattsby-Baltzer
authors.affiliation: Centre Hospitalier Universitaire de Grenoble, CHUG, Laboratoire de Parasitologie-Mycologie, Grenoble, France Université Joseph Fourier, Grenoble, France.
authors.forename: Claudine
authors.initials: C
authors.lastname: Pinel
authors.affiliation: Medical Diagnostics Discovery Department, BioMérieux, SA, France.
authors.forename: Javier
authors.initials: J
authors.lastname: Yugueros Marcos
authors.affiliation: Sahlgrenska University Hospital, Clinical Microbiology, Gothenburg.
authors.forename: Nahid
authors.initials: N
authors.lastname: Kondori
authors.affiliation: CHUG, Service de Réanimation Médicale, Grenoble, France.
authors.forename: Leila
authors.initials: L
authors.lastname: Potton
authors.affiliation: CHUG, Service d'Hématologie, Grenoble, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Thiebaut-Bertrand
authors.affiliation: Centre Hospitalier Universitaire de Grenoble, CHUG, Laboratoire de Parasitologie-Mycologie, Grenoble, France Université Joseph Fourier, Grenoble, France.
authors.forename: Hervé
authors.initials: H
authors.lastname: Pelloux
authors.affiliation: Centre Hospitalier Universitaire de Grenoble, CHUG, Laboratoire de Parasitologie-Mycologie, Grenoble, France Université Joseph Fourier, Grenoble, France.
authors.forename: Muriel
authors.initials: M
authors.lastname: Cornet
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000908:Antibodies, Fungal / Q000276:immunology*; D000946:Antigens, Fungal / Q000276:immunology*; D002175:Candida / Q000276:immunology*; D058365:Candidiasis, Invasive / Q000175:diagnosis*; D002473:Cell Wall / Q000276:immunology*; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D008297:Male; D008351:Mannans / Q000276:immunology*; D008875:Middle Aged; D010748:Phosphopeptides / Q000276:immunology*; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D000908:Antibodies, Fungal; D000946:Antigens, Fungal; D007074:Immunoglobulin G; D008351:Mannans; D010748:Phosphopeptides; C072108:phosphopeptidomannan
keywords: Candida albicans; IgG subclass antibodies; fungal infection; invasive candidiasis