[Antigen detection in invasive aspergillosis and candidosis: the Austrian experience]

In order to assess the performance of different methods for the detection of fungal antigens, data of five Austrian hospitals were evaluated. The enzyme immunoassay (EIA) Platelia Aspergillus Antigen (Bio-Rad, USA) was used for the diagnosis of invasive aspergillosis and compared with clinical data. It could be shown that it is more effective to investigate at least two sequential sera than only one sole serum. For several high-risk patients diagnosis could be improved or confirmed by investigating other body fluids such as cerebrospinal fluid or bronchoalveolar lavage fluid in addition to sera. For invasive Candida infections several diagnostic kits detecting antigens are commercially available. The performance of the EIA Platelia Candida Antigen (Bio-Rad, USA), the latexagglutination test Cand-Tec (Ramco, USA) and the detection of (1-3)-Beta-D-Glucan using the test kit Glucatell (CAPE COD, USA) were evaluated. The detection of (1-3)-Beta-D-Glucan by means of Glucatell showed the highest sensitivity as all sera of 15 patients with invasive candidosis showed positive results. The other tests showed positive and negative results independently of the occurrence of an invasive infection. However, the number of tested sera is too small to decide which test is the most appropriate for establishing an early and definite diagnosis. Prospective studies in combination with clinical data are still needed for definite evaluation.