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Journal of Clinical Microbiology, May 1999, p. 1510-1517, Vol. 37, No. 5
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.

New Enzyme Immunoassays for Sensitive Detection of Circulating Candida albicans Mannan and Antimannan Antibodies: Useful Combined Test for Diagnosis of Systemic Candidiasis

Boualem Sendid,1 Marc Tabouret,2 Jean Louis Poirot,3 Daniel Mathieu,4 Jeanine Fruit,1 and Daniel Poulain1,*

Equipe INSERM 99-15, Laboratoire de Mycologie Fondamentale et Appliquée, CH&U, Faculté de Médecine, Pôle Recherche, F-59045 Lille,1 Sanofi Diagnostics Pasteur, 59114 Steenvoorde,2 Laboratoire de Parasitologie-Mycologie, Hôpital Saint Antoine, 75012 Paris,3 and Service de Réanimation Médicale et de Médecine Hyperbare, Hôpital Calmette, Lille,4 France

Received 29 October 1998/Returned for modification 2 December 1998/Accepted 25 January 1999

Two standardized enzyme immunoassays for the serological diagnosis of candidiasis were developed. The first one detects antimannan antibodies, while the second one detects mannan with a sensitivity of 0.1 ng/ml. These tests were applied to 162 serum samples retrospectively selected from 43 patients with mycologically and clinically proven candidiasis caused by Candida albicans. Forty-three serum samples were positive for mannan, and 63 had significant antibody levels. Strikingly, only five serum samples were simultaneously positive by both tests. When the results were analyzed per patient, 36 (84%) presented at least one serum positive by one test. For 30 of them, positivity by one test was always associated with negative results by the other test for any of the tested sera. For six patients whose sera were positive for either an antigen or an antibody response, a balance between positivity by each test was evidenced by kinetic analysis of sera drawn during the time course of the infection. Controls consisted of 98 serum samples from healthy individuals, 93 serum samples from patients hospitalized in intensive care units, and 39 serum samples from patients with deep mycoses. The sensitivities and specificities were 40 and 98% and 53 and 94% for mannanemia or antibody detection, respectively. These values reached 80 and 93%, respectively, when the results of both tests were combined. These observations, which clearly demonstrate a disparity between circulation of a given mannan catabolite and antimannan antibody response, suggest that use of both enzyme immunoassays may be useful for the routine diagnosis of candidiasis.

* Corresponding author. Mailing address: Equipe INSERM 99-15, Laboratoire de Mycologie Fondamentale et Appliquée, CH&U, Faculté de Médecine, Pôle Recherche, Place de Verdun, 59045 Lille Cedex, France. Phone: 33 03 20 44 55 77. Fax: 33 03 20 44 42 64. E-mail: dan_poulain{at}compuserve.com.

Journal of Clinical Microbiology, May 1999, p. 1510-1517, Vol. 37, No. 5
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.


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