Antigenic and anticorpal diagnosis of invasive aspergillosis and candidosis in immunocompromised host

Invasive aspergillosis (IA) and candidemia are an increasing cause of morbidity and mortality in immunocompromised patients, but diagnostic procedures are often hampered by critical patients conditions. In recent years, non-culture methods have reached a standardization level suitable to be marketed...

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Main Authors: Marco Machetti, Anna Marchese
Format: Article
Language:English
Published: PAGEPress Publications 2009-03-01
Series:Microbiologia Medica
Subjects:
Online Access:http://www.pagepressjournals.org/index.php/mm/article/view/2544
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author Marco Machetti
Anna Marchese
author_facet Marco Machetti
Anna Marchese
author_sort Marco Machetti
collection DOAJ
description Invasive aspergillosis (IA) and candidemia are an increasing cause of morbidity and mortality in immunocompromised patients, but diagnostic procedures are often hampered by critical patients conditions. In recent years, non-culture methods have reached a standardization level suitable to be marketed and widely employed. A method for a panfungal antigenic diagnosis, is the detection in serum of (1→3)-ß-D-Glucan (BDG), a polisaccaridic component of fungal cell wall. Best results can be obtained in Aspergillus, Candida and Fusarium infections, while the test performs poorly with Cryptococcus and in zygomycosis. The use of this method are limited by the high costs and by the need of disposable materials certified as glucan-free, in order to avoid false positive results. Galactomannan (GM) antigen detection is a method for non-invasive diagnosis of IA. The assay, in latex agglutination (LA) and enzymeimmunoassay (EIA) format, detect GM in serum, whose presence correlates with IA. Sensitivity and specificity strongly fluctuate (50-100% and 81-98% respectively) depending on the time of sampling, the positivity cut-off employed, the concomitant administration of antifungal drugs and of some antibiotics. Nevertheless the method is a very useful and widely employed tool for the diagnosis of IA. For the diagnosis of candidemia, two Candida antigens may be detected in serum: the 56°C heat-labile antigen in LA format, and the mannan antigen, in LA and EIA format. Both the methods perform quite well, but sensitivities and specificities are not so good to allow a routinely and useful use in clinical practice.
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spelling doaj.art-00a804788dfd43d293893efd586d07d02022-12-21T23:32:04ZengPAGEPress PublicationsMicrobiologia Medica2280-64232009-03-0124110.4081/mm.2009.25441797Antigenic and anticorpal diagnosis of invasive aspergillosis and candidosis in immunocompromised hostMarco MachettiAnna MarcheseInvasive aspergillosis (IA) and candidemia are an increasing cause of morbidity and mortality in immunocompromised patients, but diagnostic procedures are often hampered by critical patients conditions. In recent years, non-culture methods have reached a standardization level suitable to be marketed and widely employed. A method for a panfungal antigenic diagnosis, is the detection in serum of (1→3)-ß-D-Glucan (BDG), a polisaccaridic component of fungal cell wall. Best results can be obtained in Aspergillus, Candida and Fusarium infections, while the test performs poorly with Cryptococcus and in zygomycosis. The use of this method are limited by the high costs and by the need of disposable materials certified as glucan-free, in order to avoid false positive results. Galactomannan (GM) antigen detection is a method for non-invasive diagnosis of IA. The assay, in latex agglutination (LA) and enzymeimmunoassay (EIA) format, detect GM in serum, whose presence correlates with IA. Sensitivity and specificity strongly fluctuate (50-100% and 81-98% respectively) depending on the time of sampling, the positivity cut-off employed, the concomitant administration of antifungal drugs and of some antibiotics. Nevertheless the method is a very useful and widely employed tool for the diagnosis of IA. For the diagnosis of candidemia, two Candida antigens may be detected in serum: the 56°C heat-labile antigen in LA format, and the mannan antigen, in LA and EIA format. Both the methods perform quite well, but sensitivities and specificities are not so good to allow a routinely and useful use in clinical practice.http://www.pagepressjournals.org/index.php/mm/article/view/2544aspergillosis, candidosis, diagnosis, antigens, antibodies
spellingShingle Marco Machetti
Anna Marchese
Antigenic and anticorpal diagnosis of invasive aspergillosis and candidosis in immunocompromised host
Microbiologia Medica
aspergillosis, candidosis, diagnosis, antigens, antibodies
title Antigenic and anticorpal diagnosis of invasive aspergillosis and candidosis in immunocompromised host
title_full Antigenic and anticorpal diagnosis of invasive aspergillosis and candidosis in immunocompromised host
title_fullStr Antigenic and anticorpal diagnosis of invasive aspergillosis and candidosis in immunocompromised host
title_full_unstemmed Antigenic and anticorpal diagnosis of invasive aspergillosis and candidosis in immunocompromised host
title_short Antigenic and anticorpal diagnosis of invasive aspergillosis and candidosis in immunocompromised host
title_sort antigenic and anticorpal diagnosis of invasive aspergillosis and candidosis in immunocompromised host
topic aspergillosis, candidosis, diagnosis, antigens, antibodies
url http://www.pagepressjournals.org/index.php/mm/article/view/2544
work_keys_str_mv AT marcomachetti antigenicandanticorpaldiagnosisofinvasiveaspergillosisandcandidosisinimmunocompromisedhost
AT annamarchese antigenicandanticorpaldiagnosisofinvasiveaspergillosisandcandidosisinimmunocompromisedhost