| DB ID | MyCo_2621 |
| Title | Presence of Candida cell wall derived polysaccharides in the sera of intensive care unit patients: relation with candidaemia and Candida colonisation |
| Year | 2014 |
| PMID | 24975380 |
| Fungal Diseases involved | Candidemia |
| Associated Medical Condition | ICU patients |
| Genus | Candida |
| Species | albicans |
| Organism | Candida albicans |
| Ethical Statement | All sera used in this study were sampled from patients followed in Lille University Hospital. When no results were available from routine tests, BDG and mannan levels were determined retrospectively from the residual frozen samples. No additional sampling was necessary. As sera were taken from a registered biological collection, patient consent was not required according to French law. Institutional review board approval was given by the Comité de Protection des Personnes Nord-Ouest IV, the ethical committee of our institution. |
| Site of Infection | None |
| Opportunistic invasive | Invasive |
| Sample type | Body fluid |
| Sample source | Serum |
| Host Group | Human |
| Host Common name | Human |
| Host Scientific name | Homo sapiens |
| Biomarker Name | Mannan-Ag |
| Biomarker Full Name | Mannan-Ag |
| Biomarker Type | Diagnostic |
| Biomolecule | Protein |
| Geographical Location | France |
| Cohort | This retrospective, case–control study involved adult patients hospitalised in a 50-bed polyvalent ICU department in a tertiary university teaching hospital. The database of the clinical mycology laboratory was screened to select patients with a positive BC for Candida over the period 2005 to 2010. We focused on patients >18 years old for whom sera were available at least 1 week before and 1 week after the day of candidaemia. The control group consisted of patients hospitalised on the same ward with Candida colonisation but no evidence of IC; five body sites (urine, anal swabs, nasal swabs, throat and tracheal aspirates when patients were intubated) were sampled once a week for the semi quantitative determination of yeast colonisation. This retrospective, case–control study included 43 ICU patients with candidaemia and 67 controls, hospitalised on the same ward and assessed weekly for yeast colonisation with simultaneous serum sampling; 340 sera taken before and after positive BCs were available for the cases group and 203 for the controls. BDG and mannan levels were determined using the Fungitell® and Platelia™ Candida Ag tests, respectively. |
| Cohort No. | 43 Patients and 63 Control |
| Age Group | > 18 |
| P Value | None |
| Sensitivity | 0.385 |
| Specificity | 0.958 |
| Positive Predictive Value | None |
| MIC | None |
| Fold Change | None |
| Pathway | None |
| Disease Introduction Mechanism | Invasive candidosis (IC) is one of the leading causes of nosocomial infection and Candida species rank fourth among the pathogens involved in bloodstream infections. Despite current progress in research and antifungal therapy, the incidence and attributable mortality of candidaemia remain high due to difficulties in the establishment of an accurate and early diagnosis. In the ICU, candidaemia has a prevalence of 7/1,000 patients, with an attributable mortality of >40% compared with 30% for bacteraemia. Mortality increases from 10% if antifungal therapy is introduced within 12 hours of the onset of candidaemia to 35% when treatment is initiated more than 48 hours after. These figures are worse in cases of septic shock due to Candida species. The challenge is therefore to manage the delay in initiation of antifungal treatment, especially as 50% of cases of IC are not detected by blood cultures (BCs) and 48 hours are generally required for yeast isolation. This low sensitivity of BCs was observed in several large postmortem studies evaluating the sensitivity of BCs for the diagnosis of deep-seated Candida invasion and was shown to range from 28% in cases of single organ candidosis to 58% in cases of disseminated IC. Improvement of BC systems has only decreased the delay in yeast isolation for certain species without any improvement in the sensitivity. Relying on BCs or waiting for BC results is thus not appropriate for managing patients at high risk of IC. |
| Technique | Assay |
| Analysis Method | ELISA Based |
| ELISA kits | Platelia™ Candida Ag (mannan) and Platelia™ Candida Ab (mannan Ab) tests ELISA Kits (Bio-Rad, Marnes la Coquette, France) |
| Assay Data | FDA- Fungitell®, Cape Cod International, Inc.; Falmounth, MA, USA |
| Validation Techniques used | Mannan-Platelia™ Candida Ag Assay |
| Up Regulation Down Regulation | Positive |
| Sequence Data | None |
| External Link | None |
