title: Candida albicans Germ-Tube Antibody: Evaluation of a New Automatic Assay for Diagnosing Invasive Candidiasis in ICU Patients.
abstract: Testing for Candida albicans germ-tube antibody IFA IgG assay (CAGTA) is used to detect invasive candidiasis infection. However, most suitable assays lack automation and rapid single-sample testing. The CAGTA assay was adapted in an automatic monotest system (invasive candidiasis [CAGTA] VirClia®IgG monotest (VirClia®), a chemiluminescence assay with ready-to-use reagents that provides a rapid objective result. CAGTA assay was compared with the monotest automatic VirClia®assay in order to establish the diagnostic reliability, accuracy, and usefulness of this method. A prospective study with 361 samples from 179 non-neutropenic critically ill adults patients was conducted, including 21 patients with candidemia, 18 with intra-abdominal candidiasis, 84 with Candida spp. colonization, and 56 with culture-negative samples, as well as samples from ten healthy subjects. Overall agreement between the two assays (CAGTA and VirCLIA) was 85.3%. These assays were compared with the gold-standard method to determine the sensitivity, specificity as well as positive and negative predictive values. In patients with candidemia, values for CAGTA and VirCLIA assays were 76.2 versus 85.7%, 80.3 versus 75.8%, 55.2 versus 52.9%, and 91.4 versus 94.3%, respectively. The corresponding values in patients with intra-abdominal candidiasis were 61.1 versus 66.7%, 80.3 versus 75.8%, 45.8 versus 42.9%, and 88.3 versus 89.3%, respectively. No differences were found according to the species of Candida isolated in culture, except for Candida albicans and C. parapsilosis, for which VirClia®was better than CAGTA. According to these results, the automated VirClia®assay was a reliable, rapid, and very easy to perform technique as tool for the diagnosis invasive candidiasis.
authors.affiliation: Unit of Infectious Disease and Clinical Microbiology, Hospital Universitario de Valme, Seville, Spain. manuel.parra.sanchez@hotmail.com.
authors.forename: Manuel
authors.initials: M
authors.lastname: Parra-Sánchez
authors.affiliation: Unit of Infectious Disease and Clinical Microbiology, Hospital Universitario de Valme, Seville, Spain.
authors.forename: Ismail
authors.initials: I
authors.lastname: Zakariya-Yousef Breval
authors.affiliation: Unit of Infectious Disease and Clinical Microbiology, Hospital Universitario de Valme, Seville, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Castro Méndez
authors.affiliation: Unit of Infectious Disease and Clinical Microbiology, Hospital Universitario de Valme, Seville, Spain.
authors.forename: Silvia
authors.initials: S
authors.lastname: García-Rey
authors.affiliation: Critical Intensive Unit, Hospital Universitario de Valme, Seville, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Loza Vazquez
authors.affiliation: Intensive Care Unit, Hospital Punta de Europa, Algeciras, Cádiz, Spain.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Úbeda Iglesias
authors.affiliation: Critical Intensive Unit, Hospital Universitario de Valme, Seville, Spain.
authors.forename: Desiree
authors.initials: D
authors.lastname: Macías Guerrero
authors.affiliation: Unit of Infectious Disease and Clinical Microbiology, Hospital Universitario de Valme, Seville, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Romero Mejías
authors.affiliation: Critical Intensive Unit, Hospital Universitario de Valme, Seville, Spain.
authors.forename: Cristobal
authors.initials: C
authors.lastname: León Gil
authors.affiliation: Unit of Infectious Disease and Clinical Microbiology, Hospital Universitario de Valme, Seville, Spain.
authors.forename: Estrella
authors.initials: E
authors.lastname: Martín-Mazuelos
mesh_terms: D000908:Antibodies, Fungal / Q000097:blood*; D057205:Automation, Laboratory / Q000379:methods*; D002176:Candida albicans / Q000276:immunology*; D058365:Candidiasis, Invasive / Q000175:diagnosis*; D006801:Humans; D007118:Immunoassay / Q000379:methods*; D007074:Immunoglobulin G / Q000097:blood; D007362:Intensive Care Units; D008163:Luminescent Measurements; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D012698:Serologic Tests / Q000379:methods*
chemical_list: D000908:Antibodies, Fungal; D007074:Immunoglobulin G
keywords: Candida albicans germ-tube antibody (CAGTA); Critically ill patients; ICU; Invasive candidiasis; Serum diagnostic test