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A Retrospective Assessment of Four Antigen Assays for the Detection of Invasive Candidiasis Among High-Risk

Barbara Hartl1,2, Iris Zeller1, Angelika Manhart1,3

  • 1Department of Laboratory Medicine, Division of Clinical Microbiology, Medical University of Vienna, Währinger Gürtel 18-20/5P, A-1090, Vienna, Austria.

Mycopathologia
|January 23, 2018
PubMed

Insights

This study evaluated mannan antigen and (1-3)-β-D-glucan assays for diagnosing invasive Candida infections in high-risk patients. Mannan assays showed potential for screening and confirmation, while Fungitell could rule out infections.

Area of Science:

  • Medical Diagnostics
  • Mycology
  • Infectious Diseases

Background:

  • Invasive Candida infections present diagnostic and therapeutic challenges due to high mortality and non-specific symptoms.
  • Accurate and timely diagnosis is crucial for effective treatment of invasive candidiasis.

Purpose of the Study:

  • To evaluate the diagnostic accuracy of three mannan antigen assays (Platelia, Platelia Plus, Serion) and one (1-3)-β-D-glucan assay (Fungitell).
  • To assess the utility of these assays in a high-risk patient population (hematological and surgical).

Main Methods:

  • Retrospective analysis of test results from 305 high-risk patients.
  • Descriptive statistics were used to assess test accuracy, including sensitivity, specificity, and predictive values.

Main Results:

  • Invasive candidiasis (IC) was confirmed in 2.95% of patients; probable/possible infections were found in 8.2%.
  • Platelia and Serion mannan assays demonstrated high specificity (98%) but low sensitivity (65%, 52%).
  • Platelia Plus showed improved sensitivity (85%) with reduced specificity (89%). Fungitell assay had high sensitivity (100%) but low specificity (58%).

Conclusions:

  • Mannan assays, particularly Platelia Plus, show promise as screening tools for invasive candidiasis.
  • Serion mannan assay may serve as a confirmatory test, while Fungitell assay is useful for excluding invasive Candida infections.
Keywords:
AntigenBDGDiagnosisFungitellInvasive candidiasisMannan

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