Early diagnosis of invasive candidiasis with mannan antigenemia and antimannan antibodies

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• 作者：Prella ; Maura ; Bille ; Jacques ; Pugnale ; Mauro ; Duvoisin ; Bertrand ; Cavassini ; Matthias ; Calandra ; Thierry ; et. al.
• 关键词：Mannan ; Antimannan ; Diagnosis ; Candidiasis ; Neutropenia
• 刊名：Diagnostic Microbiology and Infectious Disease
• 出版年：2005
• 出版时间：February, 2005
• 年：2005
• 卷：51
• 期：2
• 页码：95-101
• 全文大小：163 K

文摘

Late treatment of invasive candidiasis (IC) results in severe complications and high mortality. New tools are needed for early diagnosis. We conducted a retrospective study to assess the diagnostic utility of mannan antigenemia (Mn) and antimannan antibodies (anti-Mn) in neutropenic cancer patients at high risk for candidiasis. Twenty-eight patients with IC (based on European Organization for Research and Treatment of Cancer and Mycoses Study Group definitions) and 25 controls were studied. Mn and anti-Mn were positive (aaa0.25 ng/mL and aaa5 AU/mL, respectively) in 25/28 (89 % ) patients with candidiasis and in 4/25 (16 % ) controls: sensitivity, 89 % ; specificity, 84 % ; positive predictive value, 86 % ; negative predictive value, 88 % . In patients with hepatosplenic lesions, assessing Mn/anti-Mn shortened the median time of diagnosis of candidiasis when compared with imaging (9 versus 25 days after fever onset as first sign of infection; P < 0.001). Candidiasis was diagnosed before neutrophil recovery in 78 % and 11 % of cases with Mn/anti-Mn and radiology, respectively (P < 0.001). Mn and anti-Mn may be useful for early noninvasive diagnosis of IC.