The role of combined use of mannan antigen and anti-mannan antibodies in the diagnosis of invasive candidiasis in pediatric intensıve care unit
Yasemin Ay Altintop, Ayse Betul Ergul, Ayse Nedret Koc, Mustafa Altay Atalay
The combination of Mannan antigen and anti-mannan antibody (Ag / Ab) test is a specific diagnostic test for the diagnosis of invasive Candida (IC) infections. In this study, it was purposed to determine the roles of Ag and Ab in the diagnosis of IC in pediatric intensive care unit patients. Nineteen patients with candidiasis treated for various reasons in the pediatric intensive care unit, 25 patients colonized with Candida spp without candidemia, and 15 patients with neither candidemia nor colonized with a total number of 59, were included in the study. In colonized patients to consider colonization; cervical, nasal, throat, axillary, perineal and rectal swab cultures and urine culture were obtained every week throughout admission and Candida colonization index (CI) was calculated. Blood samples were stored at -80°C after seperated to serum form till the tests performed. Candida mannan and anti-mannan (Ab) tests were performed in duplicate in a total of 59 serum samples. Serum was assayed with Candida mannan antigen (Ag) and anti-mannan antibody (Ab) with Platelia ™ Candida Ag Plus and Platelia ™ Candida Ab Plus (Bio-Rad, Marnes las Coquette, France). The Ag and Ab values of the candidemia and colonized group were higher than the non infected and non-colonized group (p 125 was accepted, antigen positivity for C. albicans (12/22) was found to be higher than that of C.parapsilosis strains (1/4) (p> 0.05). The most compatible combination to detect IC was the combination of Ag 500 and Ab usage with a sensitivity of 57.8% and specificity of 80%. On the era of this combination, PPV was 42.8 and NPV was 80. The use of Candida mannan Ag and Ab together in children increases the diagnostic value in showing invasive candidiasis. Although concomitant use increases the diagnostic value, they need to provide higher NPV in order to exclude invasive candidiasis.
Key words: Candida mannan antigen, Candida mannan antibody, pediatric intensive care unit