Gas Chromatographic and Mass Spectrometric Techniques for the Diagnosis of Disseminated Candidiasis

Roboz, John

doi:10.1007/978-1-4899-3564-9_15

Cited by 3 publications

(2 citation statements)

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“…The highest urine D-arabinitol/L-arabinitol ratio was obtained from a patient with Candida glabrata sepsis (patient 1). The serum creatinine concentration of this patient was increased, but renal dysfunction without candidiasis does not change the D-arabinitol/L-arabinitol ratio (12). In vitro studies of arabinitol production by yeast species have shown that C. glabrata produces only trace amounts of arabinitol (1,7).…”

Section: Vol 34 1996 Urine D-arabinitol/l-arabinitol Ratio In Candimentioning

confidence: 72%

“…An important additional practical advantage of the method is that only D-arabinitol/L-arabinitol ratios need to be determined. Thus, there is no need for calibration runs for quantification or for separate creatinine determination (12). The serum D-arabinitol/L-arabinitol ratio was shown to increase in invasive candidiasis because of elevated levels of D-arabinitol (13)(14)(15).…”

Section: Vol 34 1996 Urine D-arabinitol/l-arabinitol Ratio In Candimentioning

confidence: 99%

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Diagnosis of disseminated candidiasis by measurement of urine D-arabinitol/L-arabinitol ratio

et al. 1996

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Relative amounts of D-arabinitol (fungal origin) and L-arabinitol (part of normal human metabolism) in urine were determined by gas chromatography and mass spectrometry from 61 hospitalized patients with hematological malignancies. Seventeen neutropenic patients with acute leukemia (with 53 samples) had disseminated yeast infections and received empiric antifungal therapy before confirmation of the diagnosis. Control groups consisted of 22 hematologic patients (76 samples) with either mucosal (n ‫؍‬ 10) or urinary (n ‫؍‬ 12) Candida colonization and 22 neutropenic patients (34 samples) with no clinical or laboratory signs of invasive yeast infection. Reference values were also obtained from 50 healthy adults (50 samples). The mean urine D-arabinitol/L-arabinitol ratio ؎ standard deviation (range) was 16.91 ؎ 41.79 (1.41 to 254.75) in patients with disseminated infection, 2.73 ؎ 2.48 (1.11 to 19.00) in colonized hematologic patients, 2.12 ؎ 0.84 (1.16 to 5.84) in neutropenic controls, and 1.95 ؎ 0.34 (0.97 to 3.44) in healthy adults (P < 0.001 between patients with disseminated infection and all control groups). The sensitivity and specificity of the assay for detecting disseminated yeast infection were, respectively, 88 and 91% per patient (upper limit of normal, 4.00). Seventy-one percent of patients already expressed elevated values at the onset of empiric antifungal therapy. The diagnosis of disseminated infection was confirmed on average 21.7 days after the first elevation of the D-arabinitol/L-arabinitol ratio. The method contributes to diagnosis of disseminated yeast infection and helps in monitoring patients at risk, to support the initiation of antifungal therapy at an early stage of the disease.

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Section: Vol 34 1996 Urine D-arabinitol/l-arabinitol Ratio In Candimentioning

confidence: 72%

Section: Vol 34 1996 Urine D-arabinitol/l-arabinitol Ratio In Candimentioning

confidence: 99%

Diagnosis of disseminated candidiasis by measurement of urine D-arabinitol/L-arabinitol ratio

et al. 1996

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Diagnosis and monitoring of disseminated candidiasis based on serum/urine D/L‐arabinitol ratios

Roboz

1994

Chirality

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Disseminated candidiasis, a devastating disease with high morbidity and mortality in immunosuppressed patients, is difficult to diagnose because of the protean nature of symptoms and the lack of rapid and reliable laboratory diagnostic procedures. The subject of this review is the status of gas chromatographic-mass spectrometric techniques for the determination of D-arabinitol, a unique metabolite of pathogenic Candida species, in serum and urine. The enantiomers are separated by chiral chromatography followed by specific and sensitive detection using chemical ionization and selected ion monitoring. Using D/L-arabinitol ratios, instead of individual concentrations, eliminates the need for knowing the volume of samples and for calibration curves. A new filter paper technique requires only an unmeasured drop of whole blood (venous or finger/heel puncture) or urine; paper spots are mailable. Parallel determinations of D/L-arabinitol ratios in serum and urine in normal subjects and cancer patients with both normal and increased D/L-arabinitol ratios revealed constant (1.2-1.3 range) ratios of serum D/L-arabinitol/urine D/L-arabinitol for all populations studied. Analyzing two body fluids taken at the same time increases reliability by reducing false positives.

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Arabinitol enantiomers in cerebrospinal fluid

Christensson¹,

Roboz

1991

Journal of the Neurological Sciences

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Gas Chromatographic and Mass Spectrometric Techniques for the Diagnosis of Disseminated Candidiasis

Cited by 3 publications

References 76 publications

Diagnosis of disseminated candidiasis by measurement of urine D-arabinitol/L-arabinitol ratio

Diagnosis of disseminated candidiasis by measurement of urine D-arabinitol/L-arabinitol ratio

Diagnosis and monitoring of disseminated candidiasis based on serum/urine D/L‐arabinitol ratios

Arabinitol enantiomers in cerebrospinal fluid

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