title: Association of lectin pathway proteins with intra-abdominal Candida infection in high-risk surgical intensive-care unit patients. A prospective cohort study within the fungal infection network of Switzerland.
abstract: OBJECTIVE
  Human studies on the role of mannose-binding lectin (MBL) in patients with invasive candidiasis have yielded conflicting results. We investigated the influence of MBL and other lectin pathway proteins on Candida colonization and intra-abdominal candidiasis (IAC) in a cohort of high-risk patients.
  
  
  METHODS
  Prospective observational cohort study of 89 high-risk intensive-care unit (ICU) patients. Levels of lectin pathway proteins at study entry and six MBL2 single-nucleotide polymorphisms were analyzed by sandwich-type immunoassays and genotyping, respectively, and correlated with development of heavy Candida colonization (corrected colonization index (CCI) ≥0.4) and occurrence of IAC during a 4-week period.
  
  
  RESULTS
  Within 4 weeks after inclusion a CCI ≥0.4 and IAC was observed in 47% and 38% of patients respectively. Neither serum levels of MBL, ficolin-1, -2, -3, MASP-2 or collectin liver 1 nor MBL2 genotypes were associated with a CCI ≥0.4. Similarly, none of the analyzed proteins was found to be associated with IAC with the exception of lower MBL levels (HR 0.74, p = 0.02) at study entry. However, there was no association of MBL deficiency (<0.5 μg/ml), MBL2 haplo- or genotypes with IAC.
  
  
  CONCLUSIONS
  Lectin pathway protein levels and MBL2 genotype investigated in this study were not associated with heavy Candida colonization or IAC in a cohort of high-risk ICU patients.
authors.affiliation: Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Petersgraben 4, 4031 Basel, Switzerland; Department of Biomedicine, University Hospital Basel, Petersgraben 4, 4031 Basel, Switzerland. Electronic address: michael.osthoff@usb.ch.
authors.forename: Michael
authors.initials: M
authors.lastname: Osthoff
authors.affiliation: Infectious Diseases Service, Department of Medicine, Lausanne University Hospital (CHUV), Rue du Bugnon 21, 1011 Lausanne, Switzerland.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Wojtowicz
authors.affiliation: Infectious Diseases Service, Department of Medicine, Lausanne University Hospital (CHUV), Rue du Bugnon 21, 1011 Lausanne, Switzerland.
authors.forename: Frederic
authors.initials: F
authors.lastname: Tissot
authors.affiliation: Department of Biomedicine, Aarhus University, Bartholin Building, Wilhelm Meyers Allé 4, 8000 Aarhus C, Denmark.
authors.forename: Clara
authors.initials: C
authors.lastname: Jørgensen
authors.affiliation: Department of Biomedicine, Aarhus University, Bartholin Building, Wilhelm Meyers Allé 4, 8000 Aarhus C, Denmark.
authors.forename: Steffen
authors.initials: S
authors.lastname: Thiel
authors.affiliation: Department of Infectious Diseases, University Hospital, Inselspital, Freiburgstrasse 4, 3010 Bern, Switzerland.
authors.forename: Stephan
authors.initials: S
authors.lastname: Zimmerli
authors.affiliation: Infectious Diseases Service, Department of Medicine, Lausanne University Hospital (CHUV), Rue du Bugnon 21, 1011 Lausanne, Switzerland.
authors.forename: Oscar
authors.initials: O
authors.lastname: Marchetti
authors.affiliation: Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Petersgraben 4, 4031 Basel, Switzerland; Department of Biomedicine, University Hospital Basel, Petersgraben 4, 4031 Basel, Switzerland.
authors.forename: Nina
authors.initials: N
authors.lastname: Khanna
authors.affiliation: Infectious Diseases Service, Department of Medicine, Lausanne University Hospital (CHUV), Rue du Bugnon 21, 1011 Lausanne, Switzerland.
authors.forename: Pierre-Yves
authors.initials: PY
authors.lastname: Bochud
authors.affiliation: Department of Biomedicine, University Hospital Basel, Petersgraben 4, 4031 Basel, Switzerland; Clinic for Internal Medicine, University Hospital Basel, Petersgraben 4, 4031 Basel, Switzerland.
authors.forename: Marten
authors.initials: M
authors.lastname: Trendelenburg
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002175:Candida / Q000276:immunology*; D058365:Candidiasis, Invasive / Q000235:genetics / Q000276:immunology*; D003422:Critical Care; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D007362:Intensive Care Units; D059413:Intraabdominal Infections / Q000235:genetics / Q000276:immunology*; D037102:Lectins / Q000097:blood* / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013557:Switzerland; D055815:Young Adult
chemical_list: D037102:Lectins
keywords: Candida infections; Complement system; Ficolins; Intensive-care unit; Mannose-binding lectin