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D-arabinitol--a marker for invasive candidiasis.
B Christensson1, G Sigmundsdottir, L Larsson
1Department of Infectious Diseases and Medical Microbiology, Lund University Hospital, Sweden. bertil.christensson@infek.lu.se
Medical Mycology
|January 27, 2000
Summary
D-arabinitol (DA) shows promise as a biomarker for invasive Candida infections in immunocompromised patients. Elevated DA levels can be detected early, potentially preceding blood cultures and indicating treatment response.
Area of Science:
- Biochemistry
- Clinical Diagnostics
- Mycology
Background:
- D-arabinitol (DA) is a metabolite produced by pathogenic Candida species.
- Endogenous DA and L-arabinitol (LA) are found in human body fluids, with levels increasing during renal dysfunction.
- Elevated DA/LA ratios in serum or urine are associated with invasive candidiasis in immunocompromised patients.
Purpose of the Study:
- To evaluate the diagnostic utility of the 'arabinitol method' for invasive Candida infections.
- To assess the potential of DA as an early biomarker for candidiasis.
Main Methods:
- Measurement of D-arabinitol (DA) and L-arabinitol (LA) in serum and urine.
- Gas chromatography and enzymatic analysis were used for metabolite determination.
- Prospective clinical studies in immunocompromised patients.
Main Results:
- Elevated DA/LA or DA/creatine ratios were observed in patients with invasive candidiasis.
- Positive DA results were detected days to weeks before positive blood cultures.
- Normalization of DA levels correlated with therapeutic response.
Conclusions:
- The arabinitol method shows potential for diagnosing invasive Candida infections, particularly in immunocompromised individuals.
- DA may serve as an early diagnostic marker, preceding traditional methods like blood cultures.
- Further prospective studies with robust analytical methods are required to confirm the clinical applicability of the arabinitol method.