Clinical Significance of Pastorex Candida Antigen Assay in Patients with Candidemia

Lee, Chang Jae; Shin, Jong Hee; Yi, Ji Yon; Kee, Seung Jung; Suh, Soon Pal; Ryang, Dong Wook

Abstract

BACKGROUND
The incidence of candidemia has increased, and an early differentiation of transient or central venous catheter (CVC)-related candidemia from deep-seated invasive candidiasis is often difficult. The Pastorex Candida antigen assay (Sanofi Diagnostics Pasteur, Marnes-la-Coquette, France) is known to be an useful and specific tool for the diagnosis of invasive candidiasis. We assessed the clinical significance of Pastorex Candida antigen assay in patients with candidemia.
METHODS
Eighty-five sera from 27 patients with candidemia and 42 control sera (32 patients with superficial Candida colonization and 10 healthy subjects) were tested. The Pastorex Candida latex agglutination test was performed to evaluate the presence of Candida mannan antigen. Candidemia was divided into 3 categories; (i) transient, (ii) CVC-related, and (iii) non-CVC-related persistent types.
RESULTS
Thirty-two patients with superficial Candida colonization and 10 healthy subjects were negative for the Pastorex Candida antigen. Of the 85 sera from 27 patients with candidemia, 14 (16.4%) were positive for the Pastorex Candida antigen. The Pastorex Candida antigen was detected neither in 6 patients with transient candidemia nor 15 patients with CVC-related candidemia. Conversely, it was detected in at least one serum sample of 5 of the 6 (83.3%) patients with non-CVC-related persistent candidemia. Of the 24 sera from 6 patients with non-CVC-related persistent candidemia, 14 (58.3%) were positive for the Pastorex Candida antigen. Overall, the sensitivity and specificity of the Pastorex Candida antigen assay for the diagnosis of non-CVC-related persistent candidemia were 83.3% and 100%, respectively.
CONCLUSIONS
Our data suggest that the Pastorex Candida antigen assay has a potential for the differential diagnosis of non-CVC-related persistent candidemia from transient or CVC-related candidemia.