[Serodiagnosis of fungal infection]

Serum samples from patients with candidiasis were assayed for Candida mannan by the enzyme-linked immunosorbent assay using anti-Candida albicans and anti-Candida krusei antibodies (ELISA, n = 81), for heat-labile glycoprotein by the latex agglutination test (Cand-Tec, n = 69), for D-arabinitol by the enzymatic fluorometric method, and for beta-D-glucan by the chromogenic substrate method (the G test, n = 14). The sensitivities and the specificities were 83% and 99% for mannan, 61% and 85% for heat-labile glycoprotein, 50% and 91% for D-arabinitol/creatinine ratio (> or = 1.5 mumol/mg), and 100% and 71% for beta-D-glucan (> or = 30 pg/ml), respectively. No positive reactions for the Cand-Tec and the ELISA were observed in patients with candidiasis by Candida glabrata. The sensitivity of the Cand-Tec increased with the number of samples available per patient, which was lower for patients with hematological malignancies compared with patients without hematological malignancies (25% vs. 59%). For the ELISA, however, the sensitivity was not related to the presence of hematological malignancies, nor was it related to the number of samples per patient. Among the serodiagnostic methods examined, the ELISA may be most useful in diagnosing candidiasis and in predicting the prognosis of candidiasis caused by medically important Candida strains. Of 21 patients with aspergillosis, 19 patients had antigenemia detected by the ELISA, and only 5 patients showed positive reactions with the LA test(Sanofi Diagnostics). Five of six patients with cryptococcosis revealed positive reactions with both the ELISA and the LA test(Eiken).