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Urinary D-arabinitol/L-arabinitol levels in infants undergoing long-term antibiotic therapy

Teresa J Stradomska1, Bogumila Bobula-Milewska, Anna Bauer

  • 1Department of Laboratory Diagnostics, The Children's Memorial Health Institute, Al. Dzieci Polskich 20, 04-736 Warsaw, Poland. jstradomska@op.pl

Journal of Clinical Microbiology
|October 7, 2005
PubMed

Insights

Long-term antibiotic use increases mycosis risk. In infants, the urinary D-arabinitol/L-arabinitol (D-/L-ARA) ratio, a Candida biomarker, remained within normal limits despite antibiotic therapy, except in cases of invasive candidiasis.

Area of Science:

  • Medical Mycology
  • Pediatric Infectious Diseases
  • Clinical Chemistry

Background:

  • Long-term antibiotic therapy is a significant risk factor for fungal infections (mycosis).
  • Candida species are common causes of mycosis, particularly in vulnerable populations like infants.
  • The urinary D-arabinitol/L-arabinitol (D-/L-ARA) ratio serves as a biomarker for systemic Candida infection.

Purpose of the Study:

  • To investigate the urinary D-arabinitol/L-arabinitol (D-/L-ARA) ratio in infants receiving long-term antibiotic therapy.
  • To assess the utility of the D-/L-ARA ratio as an early indicator of invasive candidiasis in this population.

Main Methods:

  • Gas chromatography with an electron capture detector was employed to measure the urinary D-/L-ARA ratio.
  • Samples were analyzed from 51 infants undergoing prolonged antibiotic treatment.
  • Ratios were compared to those of healthy controls and established upper-normal limits.

Main Results:

  • A statistically significant elevation in the D-/L-ARA ratio was observed in 47 out of 51 infants compared to healthy controls (P<0.0003).
  • Despite the elevation, the ratios in most infants remained within the upper-normal range (<3.6).
  • Four infants with suspected invasive candidiasis exhibited above-normal D-/L-ARA ratios, which normalized after fluconazole treatment.

Conclusions:

  • Long-term antibiotic therapy in infants does not typically lead to significantly elevated urinary D-/L-ARA ratios beyond normal limits.
  • The urinary D-/L-ARA ratio may be a useful biomarker for detecting invasive candidiasis in infants, as indicated by normalization after antifungal treatment.

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