D-arabinitol - a marker for invasive candidiasis

The five-carbon sugar alcohol D-arabinitol (DA) is a metabolite of most pat hogenic Candida species, in vitro as well as in vivo, and can be determined by gas chromatography or enzymatic analysis. Endogenous DA and L-arabinito l (LA) are present in human body fluids, and serum DA and LA increase in re nal dysfunction. In prospective clinical studies, elevated DA/LA or DA/crea tine ratios in serum or urine have been found in immunocompromised, usually neutropenic, patients with invasive candidiasis. In addition, positive DA results have been obtained several days to weeks before positive blood cult ures, and the normalization of DA levels has been correlated with therapeut ic response in both humans and animals. However, to date, only a few prospe ctive studies have been conducted in which adequate analytical methods were used. Thus, further investigation of various patient groups is needed to e stablish the applicability of the 'arabinitol method' in the diagnostic bat tery for invasive Candida infections.