The utility of serology in diagnosing candidosis in non-neutropenic critically ill patients

This study was carried out to evaluate the utility of serological tests in the diagnosis of candidal infections in non-neutropenic critically ill pati ents. A prospective study was carried out in a 10-bed general intensive car e unit; all patients with at least one organic sample with Candida spp. wer e included. A therapeutic-diagnostic algorithm was designed, and patients w ere treated or not, according to a classification. Blood samples were taken , and serological tests included: antigenaemia detection using two differen t commercial latex kits (Cand-Tec(R) and Pastorex(R)) and antibody detectio n by indirect haemagglutination (IHA) and indirect germ tube immunofluoresc ence (IFA). A total of 56% of antibody tests (IHA 45% and IFA 64%) and 26% of antigen tests (Cand-Tec 36% and Pastorex 17%) were positive. The sensiti vity and specificity of these tests with respect to systemic candidosis wer e 37% and 78%, respectively, for antibodies, and 0% and 90% for antigens. T here was statistical significance for mortality and low levels of antibodie s; Candida glabrata was detected by IFA and Candida tropicalis by Cand-Tec. Serological tests may help to define the prognosis of these patients and t o support the detection of specific Candida species.