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Diagnostic value of determination of serum mannan concentrations in patients with candiduria
S Tokunaga1, M Ohkawa, M Takashima
1Department of Urology, School of Medicine, Kanazawa University, Takaramachi, Japan.
Abstract:
The diagnostic value of determination of serum mannan levels was studied in 41 patients with candiduria and 20 control patients without candiduria. The patients with candiduria comprised 18 asymptomatic afebrile patients (group 1) and 23 febrile patients with suspected Candida pyelonephritis (group 2). Mannan antigenemia (> or equal to 0.5 ng/ml) was detected in 14 patients in group 2, this rate being significantly higher than the rate of four patients in group 1 (p < 0.05) and none in the control group (p < 0.01). Serum mannan levels decreased gradually and became undetectable in six patients in whom therapy with an anticandidal agent was effective. Determination of serum mannan levels may be a useful parameter in diagnosing Candida pyelonephritis and deciding on effective treatment.
Insights
Serum mannan levels show diagnostic value for candiduria, particularly in suspected Candida pyelonephritis. Elevated mannan antigenemia indicates infection, and decreasing levels suggest effective anticandidal treatment.
Area of Science:
- Clinical Microbiology
- Infectious Diseases
- Diagnostic Immunology
Background:
- Candiduria, the presence of Candida in urine, can range from asymptomatic colonization to invasive pyelonephritis.
- Accurate diagnosis of invasive candidal infections, such as Candida pyelonephritis, is crucial for timely and effective treatment.
- Current diagnostic methods may have limitations in differentiating colonization from invasive disease.
Purpose of the Study:
- To evaluate the diagnostic utility of serum mannan levels in patients with candiduria.
- To assess the correlation between serum mannan levels and the presence of suspected Candida pyelonephritis.
- To determine if serum mannan levels can monitor treatment response in candidal infections.
Main Methods:
- Serum mannan levels were measured in 41 patients with candiduria and 20 controls.
- Patients with candiduria were stratified into asymptomatic (group 1) and febrile with suspected pyelonephritis (group 2).
- Statistical analysis compared mannan levels across groups and assessed changes during effective therapy.
Main Results:
- Significantly higher rates of mannan antigenemia (≥0.5 ng/ml) were observed in febrile patients with suspected pyelonephritis (group 2) compared to asymptomatic patients (group 1) and controls (p < 0.05 and p < 0.01, respectively).
- Mannan antigenemia was detected in 14 patients in group 2, versus 4 in group 1 and 0 in controls.
- Serum mannan levels decreased and became undetectable in patients responding to anticandidal therapy.
Conclusions:
- Determination of serum mannan levels is a valuable diagnostic parameter for identifying Candida pyelonephritis in patients with candiduria.
- Serum mannan levels can serve as an indicator for monitoring the effectiveness of anticandidal treatment.
- This biomarker aids in distinguishing invasive candidal infection from asymptomatic colonization.