The role of combined use of mannan antigen and anti-mannan antibodies in the diagnosis of invasive candidiasis in pediatric intensıve care unit
The combination of Mannan antigen and anti-mannan antibody (Ag / Ab) test is a specific diagnostic test for the diagnosis of invasive Candida (IC) infections. In this study, it was purposed to determine the roles of Ag and Ab in the diagnosis of IC in pediatric intensive care unit patients. Nineteen patients with candidiasis treated for various reasons in the pediatric intensive care unit, 25 patients colonized with Candida spp without candidemia, and 15 patients with neither candidemia nor colonized with a total number of 59, were included in the study. In colonized patients to consider colonization; cervical, nasal, throat, axillary, perineal and rectal swab cultures and urine culture were obtained every week throughout admission and Candida colonization index (CI) was calculated. Blood samples were stored at -80°C after seperated to serum form till the tests performed. Candida mannan and anti-mannan (Ab) tests were performed in duplicate in a total of 59 serum samples. Serum was assayed with Candida mannan antigen (Ag) and anti-mannan antibody (Ab) with Platelia ™ Candida Ag Plus and Platelia ™ Candida Ab Plus (Bio-Rad, Marnes las Coquette, France). The Ag and Ab values of the candidemia and colonized group were higher than the non infected and non-colonized group (p 125 was accepted, antigen positivity for C. albicans (12/22) was found to be higher than that of C.parapsilosis strains (1/4) (p> 0.05). The most compatible combination to detect IC was the combination of Ag 500 and Ab usage with a sensitivity of 57.8% and specificity of 80%. On the era of this combination, PPV was 42.8 and NPV was 80. The use of Candida mannan Ag and Ab together in children increases the diagnostic value in showing invasive candidiasis. Although concomitant use increases the diagnostic value, they need to provide higher NPV in order to exclude invasive candidiasis.
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1. León C, Ruiz-Santana S, Saavedra P, et al. 2006. A bedside scoring system (“Candida score”) for early antifungal treatment in nonneutropenic critically ill patients with Candida colonization. Crit Care Med. 34: 730-7.2. Brissaud O, Guichoux J, Harambat J, et al. 2012. Invasive fungal disease in PICU: epidemiology and risk factors. Ann Intensive Care. 2:6.
3. Pittet D, Monod M, Suter PM, et al. 1994. Candida colonization and subsequent infections in critically ill surgical patients. Ann Surg. 220: 751.
4. León C, Ruiz-Santana S, Saavedra P, et al. 2009. Usefulness of the “Candida score” for discriminating between Candida colonization and invasive candidiasis in non-neutropenic critically ill patients: a prospective multicenter study. Crit Care Med. 37:1624-33.
5. Yera H, Sendid B, Francois N, et al. 2001. Contribution of serological tests and blood culture to the early diagnosis of systemic candidiasis. Eur J Clin Microbiol Infect Dis. 20: 864-70.
6. Martínez JP, Gil ML, López-Ribot JL, et al. 1998. Serologic response to cell wall mannoproteins and proteins of Candida albicans. Clin Microbiol Rev. 11:121-41.
7. Sendid B, Poirot JL, Tabouret M, et al. 2002. Combined detection of mannanaemia and anti-mannan antibodies as a strategy for the diagnosis of systemic infection caused by pathogenic Candida species. J Med Microbiol. 51:433-42.
8. Chumpitazi BF, Lebeau B, Faure-Cognet O, et al. 2014. Characteristic and clinical relevance of Candida mannan test in the diagnosis of probable invasive candidiasis. Med Mycol. 52:462-71.
9. Mikulska M, Furfaro E, Viscoli C. 2015. Non-cultural methods for the diagnosis of invasive fungal disease. Expert Rev Anti Infect Ther. 13:103- 17.
10. Oz Y, Kiraz N. 2011. Diagnostic methods for fungal infections in pediatric patients: microbiological, serological and molecular methods. Expert Rev Anti Infect Ther. 9:289-98.
11. Agvald-Öhman C, Klingspor L, Hjelmqvist H, et al. 2008. Invasive candidiasis in long-term patients at a multidisciplinary intensive care unit: Candida colonization index, risk factors, treatment and outcome. Scand J Infect Dis. 40:145-53.
12. Caggiano G, Puntillo F, Coretti C, et al. 2011. Candida colonization index in patients admitted to an ICU. Int J Mol Sci. 12:7038-47.
13. Leroy G, Lambiotte F, Thévenin D, et al. 2011. Evaluation of" Candida score" in critically ill patients: a prospective, multicenter, observational, cohort study. Ann Intensive Care. 1:50.
14. Pana Z-D, Vikelouda K, Roilides E. 2016. Diagnosis of invasive fungal diseases in pediatric patients. Expert Rev Anti Infect Ther. 14:1203-13.
15. Clancy CJ, Nguyen MH. 2018. Diagnosing invasive candidiasis. J Clin Microbiol. JCM. 01909-17.
16. Wey SB, Mori M, Pfaller MA, et al. 1989. Risk factors for hospital-acquired candidemia: a matched case-control study. Arch Intern Med. 149:2349-53.
17. Huppler AR, Fisher BT, Lehrnbecher T, et al. 2017. Role of Molecular Biomarkers in the Diagnosis of Invasive Fungal Diseases in Children. J Pediatric Infect Dis Soc. 6:S32-S44.
18. Verduyn Lunel F, Donnelly J, Van Der Lee H, et al. 2009. Circulating Candida‐specific anti‐mannan antibodies precede invasive candidiasis in patients undergoing myelo‐ablative chemotherapy. Clin Microbiol Infect. 15:380-6.
19. Mokaddas E, Burhamah MH, Khan ZU, et al. 2010. Levels of (1→ 3)-β-Dglucan, Candida mannan and Candida DNA in serum samples of pediatric cancer patients colonized with Candida species. BMC Infect Dis. 10:292.
20. Rao DR, Ghosh A, Singhi S, et al. 2002. Mannan antigen detection in the diagnosis of patients with invasive candidiasis. Indian J Med Res. 116:13.
21. Alam FF, Mustafa AS, Khan ZU. 2007. Comparative evaluation of (1, 3)-β-D-glucan, mannan and anti-mannan antibodies, and Candida speciesspecific snPCR in patients with candidemia. BMC Infect Dis. 7:103.
22. Prella M, Bille J, Pugnale M, et al. 2005. Early diagnosis of invasive candidiasis with mannan antigenemia and antimannan antibodies. Diagn Microbiol Infect Dis. 51:95-101.
23. Sendid B, Tabouret M, Poirot JL, et al. 1999. New enzyme immunoassays for sensitive detection of circulatingCandida albicans mannan and antimannan antibodies: useful combined test for diagnosis of systemic candidiasis. J Clin Microbiol. 37:1510-7.
24. Rouzé A, Loridant S, Poissy J, et al. 2017. Biomarker-based strategy for early discontinuation of empirical antifungal treatment in critically ill patients: a randomized controlled trial. Intensive Care Med. 43:1668-77.
25. Mikulska M, Calandra T, Sanguinetti M, et al. 2010. The use of mannan antigen and anti-mannan antibodies in the diagnosis of invasive candidiasis: recommendations from the Third European Conference on Infections in Leukemia. Crit Care. 14:R222.
26. Jacquinot PM, Plancke Y, Sendid B, et al. 1998. Nature of Candida albicansderived carbohydrate antigen recognized by a monoclonal antibody in patient sera and distribution over Candida speci
- ISSN: 2147-0634
- Yayın Aralığı: Yılda 4 Sayı
- Başlangıç: 2012
- Yayıncı: Effect Publishing Agency ( EPA )
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