D-ARABINITOL VERSUS MANNAN ANTIGEN AND CANDIDAL PROTEIN ANTIGEN AS A SERUM MARKER FOR CANDIDA PYELONEPHRITIS

To evaluate serum markers for the diagnosis of Candida pyelonephritis, levels of D-arabinitol, candidal mannan antigen and candidal protein antigen were measured using an enzymatic fluorometric assay, an enzyme immunoassay and a latex agglutination assay, respectively. The study group comprised 36 patients with candiduria (11 disseminated candidias is, 9 Candida pyelonephritis and 16 colonization) and 27 without candi duria. The D-arabinitol/creatinine ratio was the only marker that diff erentiated between Candida pyelonephritis and colonization (p < 0.01). Using the cutoff values (1.4 mu mol/mg of D-arabinitol/creatinine rat io, 0.28 of mannan/creatinine ratio (x 10(4)) and 1:4 of protein antig en titer) D-arabinitol/creatinine ratio showed the highest sensitivity in Candida pyelonephritis (77.8%) as compared to mannan/creatinine ra tio (55.6 %) and protein antigen titer (11.1 %) although there were no differences in specificity, positive predictive value or negative pre dictive value. These results suggest that D-arabinitol/creatinine rati o is the most useful marker of Candida pyelonephritis.