[Evaluation of serological and biochemical diagnosis of candidemia]

In order to compare 4 serological and biochemical diagnostic tests, HA-test (Candida-HA-test), Cand-Tec, D-arabinitol detective test and Fungal Index (F.I.) were carried out in a total of 8 patients with candidemia, 6 were diagnosed to have systemic candidosis and 2 transient fungemia due to colonized catheters. Rabbits were given venous injections of 1.0 x 10(6) CFU (1 ml) of living Candida albicans type A to study the 4 diagnostic methods by sequential blood culture. Prior to clinical administration of antimycotics the diagnostic methods produced almost the same positive ratios. After administration of antimycotics, the HA-test became positive later than Cand-Tec or D-arabinitol because it detected antibodies in the serum, but its conversion to negative also tended to be slightly slower. Accordingly, the HA-test is considered to be useful for retrospective diagnosis of systemic candidosis. In Cand-Tec, D-arabinitol and F.I., the cases where reversion to normal was not achieved soon after therapy were intractable. In one case, the antigen values after therapy were four times as high as prior to treatment. To differentiate the two cases with transient fungemia from those with systemic candidosis HA- and D-arabinitol tests were considered to be superior to Cand-Tec and F.I. In the experiments with rabbits Cand-Tec was, in spite of its being positive in blood culture, always negative.