Measurement of Serum d -Arabinitol/Creatinine Ratios for Initial Diagnosis and for Predicting Outcome in an Unselected, Population-Based Sample of Patients with Candida Fungemia
| Autor: | Sharon Huie, Andre N. Sofair, Sheldon Campbell, Siew Fah Yeo, Amanda J. Durante, Brian Wong |
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| Rok vydání: | 2006 |
| Předmět: |
Adult
Microbiology (medical) medicine.medical_specialty Pathology Adolescent Mycology Neutropenia Sensitivity and Specificity Gastroenterology chemistry.chemical_compound Sugar Alcohols Internal medicine medicine Humans Child Fungemia Mycosis Aged Aged 80 and over Creatinine Candida glabrata biology business.industry Candidiasis Infant Cancer Middle Aged medicine.disease biology.organism_classification Corpus albicans chemistry Child Preschool Unselected population business |
| Zdroj: | Journal of Clinical Microbiology. 44:3894-3899 |
| ISSN: | 1098-660X 0095-1137 |
| Popis: | d -Arabinitol (DA) is a useful diagnostic marker for candidiasis in patients with neutropenia and other high-risk groups, but its use in unselected patients with a broad range of underlying diseases and conditions has not been studied. We used an automated enzymatic fluorometric assay to measure serum DA/creatinine ratios (DA/cr's) in 30 healthy adults, 100 hospitalized controls without Candida fungemia, and 83 patients from a study of all Candida fungemias in Connecticut between October 1998 and September 1999. Sixty-three of 83 (76%) fungemic patients and 11 of 100 (11%) nonfungemic controls had serum DA/cr's ≥3.9 μM/mg/dl (mean + 3 standard deviations for 30 healthy adults). High serum DA/cr's were less frequent in patients with cancer or fungemia caused by the DA nonproducer Candida glabrata than in patients with cancer or fungemia caused by a DA producer, C. albicans , C. tropicalis , or C. parapsilosis . The serum DA/cr was first ≥3.9 μM/mg/dl before, on the same day as, or after the first positive blood culture was drawn for 30 (36%), 22 (27%), and 11 (13%) fungemia patients, respectively. Mortality did not differ significantly among the patients with high or normal initial or peak serum DA/cr's, but mortality was higher if any serum DA/cr value was ≥3.9 μM/mg/dl 3 or more days after the onset of fungemia (18/27 versus 4/24 patients, respectively; P < 0.001). We conclude that serum DA/cr's are useful both for the initial diagnosis of Candida fungemia and for prognostic purposes for unselected patients with a broad range of underlying diseases and conditions. |
| Databáze: | OpenAIRE |
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