DETERMINATION OF SERUM ARABINITOL LEVELS BY MASS-SPECTROMETRY IN PATIENTS WITH POSTOPERATIVE CANDIDIASIS

A combined gas chromatography-mass spectrometry (GC-MS) technique was used for serial determination of serum arabinitol levels in patients w ith postoperative candidiasis. Forty subjects were investigated, 18 pa tients with candidiasis, 7 patients with superficial Candida colonizat ion and 15 postoperative control patients. The arabinitol levels were highly elevated, slightly elevated and normal in 13, 1 and 4 patients respectively with candidiasis; in 2,2 and 3 colonized patients and in 1, 1 and 13 control patients (p < 0.001, chi2, between all the groups) . The sensitivity of a single arabinitol determination for detection o f postoperative candidiasis was 27.6 % and the specificity 89.2 %. Use of multiple samples improved sensitivity up to 72.2 % per patient (12 3 samples) with a specificity of 86.4 %. Highly elevated arabinitol co ncentrations were detected in only one patient before the onset of the rapy. Determination of arabinitol levels by GC-MS is a specific test f or diagnosing candidiasis, but multiple samples are required for adequ ate sensitivity, and the initiation of therapy must still be on an emp irical basis.