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. 1997 Apr;35(4):903–906. doi: 10.1128/jcm.35.4.903-906.1997

Assessment of detection of Candida mannoproteinemia as a method to differentiate central venous catheter-related candidemia from invasive disease.

C Girmenia 1, P Martino 1, F De Bernardis 1, A Cassone 1
PMCID: PMC229699  PMID: 9157151

Abstract

The proper management of candidemic patients is controversial because of the difficulties of an early differentiation of central venous catheter (CVC)-related candidemia from deep-seated invasive Candida infection. In particular, more information on possible markers of invasive disease is needed. We performed a retrospective, pilot investigation to assess the diagnostic potential of a dot immunobinding assay for Candida mannoprotein antigen in serial serum samples from 31 candidemic patients in the setting of hematologic malignancy. Mannoproteinemia (antigenemia) was detected in 1 of 14 (7.1%) patients with transient or CVC-related candidemia and in 13 of 17 (76.5%) patients with non-CVC-related persistent candidemia. Of the 11 subjects of this latter group with documented tissue invasion, 10 (91%) were antigenemic. The patients belonging to the different categories did not significantly differ in the duration of candidemia, nor was there any significant difference among the different groups of subjects either in the number of serum samples examined or in their collection time during candidemia. The day of the first antigenemic sample during candidemia greatly varied among subjects with invasive infection, although on average mannoproteinemia was detectable by the first week of candidemia. In summary, our data demonstrate a correlation between mannoproteinemia and tissue invasion by Candida spp. in candidemic patients and suggest that mannoprotein detection by our method has a potential for the diagnosis of invasive candidiasis in these subjects.

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Selected References

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  1. Buckley H. R., Richardson M. D., Evans E. G., Wheat L. J. Immunodiagnosis of invasive fungal infection. J Med Vet Mycol. 1992;30 (Suppl 1):249–260. doi: 10.1080/02681219280000941. [DOI] [PubMed] [Google Scholar]
  2. Cabezudo I., Pfaller M., Gerarden T., Koontz F., Wenzel R., Gingrich R., Heckman K., Burns C. P. Value of the Cand-Tec Candida antigen assay in the diagnosis and therapy of systemic candidiasis in high-risk patients. Eur J Clin Microbiol Infect Dis. 1989 Sep;8(9):770–777. doi: 10.1007/BF02185843. [DOI] [PubMed] [Google Scholar]
  3. Cassone A., Torosantucci A., Boccanera M., Pellegrini G., Palma C., Malavasi F. Production and characterisation of a monoclonal antibody to a cell-surface, glucomannoprotein constituent of Candida albicans and other pathogenic Candida species. J Med Microbiol. 1988 Dec;27(4):233–238. doi: 10.1099/00222615-27-4-233. [DOI] [PubMed] [Google Scholar]
  4. De Bernardis F., Girmenia C., Boccanera M., Adriani D., Martino P., Cassone A. Use of a monoclonal antibody in a dot immunobinding assay for detection of a circulating mannoprotein of Candida spp. in neutropenic patients with invasive candidiasis. J Clin Microbiol. 1993 Dec;31(12):3142–3146. doi: 10.1128/jcm.31.12.3142-3146.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Edwards J. E., Jr Should all patients with candidemia be treated with antifungal agents? Clin Infect Dis. 1992 Sep;15(3):422–423. doi: 10.1093/clind/15.3.422. [DOI] [PubMed] [Google Scholar]
  6. Fraser V. J., Jones M., Dunkel J., Storfer S., Medoff G., Dunagan W. C. Candidemia in a tertiary care hospital: epidemiology, risk factors, and predictors of mortality. Clin Infect Dis. 1992 Sep;15(3):414–421. doi: 10.1093/clind/15.3.414. [DOI] [PubMed] [Google Scholar]
  7. Fujita S., Hashimoto T. Detection of serum Candida antigens by enzyme-linked immunosorbent assay and a latex agglutination test with anti-Candida albicans and anti-Candida krusei antibodies. J Clin Microbiol. 1992 Dec;30(12):3132–3137. doi: 10.1128/jcm.30.12.3132-3137.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Girmenia C., Martino P., De Bernardis F., Gentile G., Boccanera M., Monaco M., Antonucci G., Cassone A. Rising incidence of Candida parapsilosis fungemia in patients with hematologic malignancies: clinical aspects, predisposing factors, and differential pathogenicity of the causative strains. Clin Infect Dis. 1996 Sep;23(3):506–514. doi: 10.1093/clinids/23.3.506. [DOI] [PubMed] [Google Scholar]
  9. Horn R., Wong B., Kiehn T. E., Armstrong D. Fungemia in a cancer hospital: changing frequency, earlier onset, and results of therapy. Rev Infect Dis. 1985 Sep-Oct;7(5):646–655. doi: 10.1093/clinids/7.5.646. [DOI] [PubMed] [Google Scholar]
  10. Komshian S. V., Uwaydah A. K., Sobel J. D., Crane L. R. Fungemia caused by Candida species and Torulopsis glabrata in the hospitalized patient: frequency, characteristics, and evaluation of factors influencing outcome. Rev Infect Dis. 1989 May-Jun;11(3):379–390. doi: 10.1093/clinids/11.3.379. [DOI] [PubMed] [Google Scholar]
  11. Lecciones J. A., Lee J. W., Navarro E. E., Witebsky F. G., Marshall D., Steinberg S. M., Pizzo P. A., Walsh T. J. Vascular catheter-associated fungemia in patients with cancer: analysis of 155 episodes. Clin Infect Dis. 1992 Apr;14(4):875–883. doi: 10.1093/clinids/14.4.875. [DOI] [PubMed] [Google Scholar]
  12. Martino P., Girmenia C., Micozzi A., Raccah R., Gentile G., Venditti M., Mandelli F. Fungemia in patients with leukemia. Am J Med Sci. 1993 Oct;306(4):225–232. doi: 10.1097/00000441-199310000-00004. [DOI] [PubMed] [Google Scholar]
  13. Martino P., Meloni G., Cassone A. Candidal endocarditis and treatment with fluconazole and granulocyte-macrophage colony-stimulating factor. Ann Intern Med. 1990 Jun 15;112(12):966–967. doi: 10.7326/0003-4819-112-12-966_2. [DOI] [PubMed] [Google Scholar]
  14. Matthews R., Burnie J. Diagnosis of systemic candidiasis by an enzyme-linked dot immunobinding assay for a circulating immunodominant 47-kilodalton antigen. J Clin Microbiol. 1988 Mar;26(3):459–463. doi: 10.1128/jcm.26.3.459-463.1988. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Meunier-Carpentier F., Kiehn T. E., Armstrong D. Fungemia in the immunocompromised host. Changing patterns, antigenemia, high mortality. Am J Med. 1981 Sep;71(3):363–370. doi: 10.1016/0002-9343(81)90162-5. [DOI] [PubMed] [Google Scholar]
  16. Mitsutake K., Miyazaki T., Tashiro T., Yamamoto Y., Kakeya H., Otsubo T., Kawamura S., Hossain M. A., Noda T., Hirakata Y. Enolase antigen, mannan antigen, Cand-Tec antigen, and beta-glucan in patients with candidemia. J Clin Microbiol. 1996 Aug;34(8):1918–1921. doi: 10.1128/jcm.34.8.1918-1921.1996. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Ness M. J., Vaughan W. P., Woods G. L. Candida antigen latex test for detection of invasive candidiasis in immunocompromised patients. J Infect Dis. 1989 Mar;159(3):495–502. doi: 10.1093/infdis/159.3.495. [DOI] [PubMed] [Google Scholar]
  18. Reboli A. C. Diagnosis of invasive candidiasis by a dot immunobinding assay for Candida antigen detection. J Clin Microbiol. 1993 Mar;31(3):518–523. doi: 10.1128/jcm.31.3.518-523.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Rex J. H., Bennett J. E., Sugar A. M., Pappas P. G., van der Horst C. M., Edwards J. E., Washburn R. G., Scheld W. M., Karchmer A. W., Dine A. P. A randomized trial comparing fluconazole with amphotericin B for the treatment of candidemia in patients without neutropenia. Candidemia Study Group and the National Institute. N Engl J Med. 1994 Nov 17;331(20):1325–1330. doi: 10.1056/NEJM199411173312001. [DOI] [PubMed] [Google Scholar]
  20. Rex J. H. Editorial response: catheters and candidemia. Clin Infect Dis. 1996 Mar;22(3):467–470. doi: 10.1093/clinids/22.3.467. [DOI] [PubMed] [Google Scholar]
  21. Venditti M., De Bernardis F., Micozzi A., Pontieri E., Chirletti P., Cassone A., Martino P. Fluconazole treatment of catheter-related right-sided endocarditis caused by Candida albicans and associated with endophthalmitis and folliculitis. Clin Infect Dis. 1992 Feb;14(2):422–426. doi: 10.1093/clinids/14.2.422. [DOI] [PubMed] [Google Scholar]
  22. Walsh T. J., Hathorn J. W., Sobel J. D., Merz W. G., Sanchez V., Maret S. M., Buckley H. R., Pfaller M. A., Schaufele R., Sliva C. Detection of circulating candida enolase by immunoassay in patients with cancer and invasive candidiasis. N Engl J Med. 1991 Apr 11;324(15):1026–1031. doi: 10.1056/NEJM199104113241504. [DOI] [PubMed] [Google Scholar]
  23. Wingard J. R., Merz W. G., Saral R. Candida tropicalis: a major pathogen in immunocompromised patients. Ann Intern Med. 1979 Oct;91(4):539–543. doi: 10.7326/0003-4819-91-4-539. [DOI] [PubMed] [Google Scholar]

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