Arabinitol is a pentitol generated in large quantitites by several species of Candida, including Candida albicans. The level of arabinitol in the sera of infected animals and humans was determined by gas-liquid chromatography of an acetone extract of the serum. Experimentally infected mice with pyelonephritis due to C. albicans had elevated levels of arabinitol; rabbits with pyelonephritis did not have elevated levels, nor did rabbits with catheter-induce cystitis, but rabbits with endocarditis developed elevated levels of arabinitol shortly before death. A prospective study in patients clinically suspected of having invasive candidiasis failed to show elevated levels of arabinitol in most. Mice and patients not colonized or infected with yeasts but with renal failure had high serum levels of arabinitol. The data indicate that an elevated level of arabinitol in the serum of a patient without renal disease is suggestive of invasive candidiasis, but normal serum levels do not contradict the diagnosis.
The host defects that increase either the frequency or the severity of certain infections in older persons are reviewed briefly. The major defect is in the functioning of the lymphocyte-macrophage system; this is expressed as deficits in cutaneous reactivity and T cell response after antigenic stimulation. A review of induced infections in experimental animals shows results generally consistent with the data in humans. Infections due to Listeria monocytogenes, Salmonella typhimurium, and Toxoplasma gondii all appear to be worse in senescent mice; each of these organisms is dealt with primarily by the lymphocyte-macrophage system. We have recently completed studies on aged mice infected with Staphylococcus aureus, an organism dealt with primarily by polymorphonuclear leukocytes rather than the lymphocyte-macrophage system. Surprisingly, staphylococcal infections were much worse in older animals. These studies suggest that in older mice there may also be a defect either in polymorphonuclear leukocyte mobilization and/or function or in the ability of older mice to resist the lethal effects of staphylococcal toxins.
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