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Journal of Clinical Microbiology, April 2000, p. 1439-1443, Vol. 38, No. 4
Departments of Internal
Medicine1 and Laboratory
Medicine,4 Yale University School of Medicine,
New Haven, and Infectious Diseases2
and Laboratory Medicine and Pathology,3
Veterans Affairs Medical Center, West Haven, Connecticut
Received 20 September 1999/Returned for modification 23 December
1999/Accepted 2 February 2000
A rapid enzymatic fluorometric assay for measuring
D-arabinitol in serum was developed using recombinant
D-arabinitol dehydrogenase from Candida
albicans (rArDH). rArDH was produced in Escherichia coli and purified by dye-ligand affinity chromatography. rArDH was highly specific for D-arabinitol, cross-reacting only
with xylitol (4.9%) among all polyols tested. A Cobas Fara II
centrifugal autoanalyzer (Roche) was used to measure NADH
fluorometrically when rArDH and NAD were added to serum extracts, and
D-arabinitol concentrations were calculated from standard
curves derived from pooled human serum containing known amounts of
D-arabinitol. The method was precise (mean intra-assay
coefficients of variation [CVs], 0.8%, and mean interassay CVs,
1.6%) and rapid (3.5 min per assay) and showed excellent recovery of
added D-arabinitol in serum (mean recovery rate, 101%).
The mean and median D-arabinitol/creatinine ratios were
2.74 and 2.23 µM/mg/dl, respectively, for the 11 patients with
candidemia compared to 1.14 and 1.23 µM/mg/dl, respectively, for 10 healthy controls (P < 0.01). These results confirm
earlier studies showing that serum D-arabinitol measurement
may help to promptly diagnose invasive candidiasis. The technique shows
a significant improvement in terms of accuracy, cost, simplicity, specificity, and speed compared with gas chromatography, mass spectrometry, and earlier enzymatic assays.
0095-1137/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.
A Rapid, Automated Enzymatic Fluorometric Assay for
Determination of D-Arabinitol in Serum
*
Corresponding author. Mailing address: VA Medical
Center, Infectious Diseases, 950 Campbell Ave., 111-I, West Haven, CT
06516. Phone: (203) 932-5711, ext. 5168. Fax: (203) 937-4851. E-mail: brian.wong{at}yale.edu.
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