WESTERN-BLOT-ANALYSIS OF THE IMMUNE-RESPONSE TO CANDIDA-ALBICANS ANTIGENS IN 391 LONG-TERM INTENSIVE-CARE PATIENTS

The aim of this study was to determine, using Western blot, the preval ence of anti-Candida albicans antibodies in long-term intensive care p atients and to characterize specific immune responses that may only oc cur in patients with invasive candidosis. A total of 1751 serum sample s from 391 patients of a German multicentre study, which was designed to determine the incidence of systemic candidosis, was examined. Signi ficantly enhanced antibody production against specific antigens was ob served in several subgroups of patients, i.e. those with underlying di sease of the pancreas (29 kDa, P = 0.006), cholecystolithiasis (47 kDa , P = 0.029), gastrointestinal tract disease (47 kDa, P = 0.03), stero id therapy (58 kDa, P = 0.02), thrush (58 kDa, P = 0.032), urogenital infection (58 kDa, P = 0.034), Candida antigen titre greater than or e qual to 1:4 (58 kDa, P = 0.002) and positive fungal culture (36 kDa, P = 0.03) and those who had died (36 kDa, P = 0.011). In contrast to ea rlier publications, an immune response against the 29 and 47 kDa antig ens was relatively common among long-term intensive care patients (37% and 70% antibody positive respectively). A single antigen that provid ed satisfactory sensitivity and specificity for the discrimination bet ween fungal infection and no fungal infection or between superficial a nd invasive fungal infection was not identified in this study.