New Approach for Diagnosis of Candidemia Based on Detection of a 65-Kilodalton Antigen

Berzaghi, Rodrigo; Colombo, Arnaldo Lopes; Machado, Antônia Maria de Oliveira; Camargo, Zoilo Pires de

doi:10.1128/cvi.00176-09

Cited by 18 publications

(17 citation statements)

References 50 publications

(38 reference statements)

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“…119 Some tests for detecting Candida protein antigens have been hypothesized or developed, but their applicability in clinical practice remains low because of low sensitivity, possibly linked to rapid clearance, formation of immune complexes, and low serum concentrations. [127][128][129][130][131][132][133][134][135] Suboptimal performances and lack of standardization are also important limitations of tests based on the detection of the Candida sugar alcohol D-arabinitol in serum. 128,133,136,137 Combinations of Available Antigen/Antibody Tests Some authors have tried to combine the use of available tests, to improve their usefulness in guiding pre-emptive therapeutic decisions.…”

Section: Mannan and Antimannanmentioning

confidence: 99%

Diagnosis and Treatment of Candidemia in the Intensive Care Unit

Bassetti

Giacobbe

Vena

et al. 2019

Semin Respir Crit Care Med

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Candidemia is the fourth most frequent health care-associated bloodstream infection, and the most frequent severe fungal infection developing in critically ill patients in intensive care units (ICUs). Diagnosis of candidemia in ICU patients is a complex task made of both early and late assessments involving both conventional diagnostic methods and novel rapid tests. Management strategies to optimize treatment of candidemia can be challenging and include starting early adequate therapy, use of an adequate dose and duration of therapy, de-escalating treatment whenever possible, and early discontinuation of useless antifungals in those with no definitive diagnosis of fungal infection. Herein, we will discuss recent epidemiological data on candidemia in ICUs and current diagnostic techniques before concentrating on antifungal treatments.

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Section: Mannan and Antimannanmentioning

confidence: 99%

Diagnosis and Treatment of Candidemia in the Intensive Care Unit

Bassetti

Giacobbe

Vena

et al. 2019

Semin Respir Crit Care Med

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“…85 Preliminary results using the Candida 65-kDa antigen to identify Candida infections in ICU patients are promising; however, further research is needed to assess its utility. 86…”

Section: Other Methodsmentioning

confidence: 99%

CandidaProphylaxis and Therapy in the ICU

Echeverria

Kett²,

Azoulay

2011

Semin Respir Crit Care Med

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The incidence of invasive candidiasis in critically ill patients has increased over the past decade and is associated with considerable morbidity and mortality. CANDIDA is identified in up to 17% of ICU patients, with candidemia occurring in ∼1%. CANDIDA ALBICANS continues to account for approximately half of the invasive candidiasis cases, with non- ALBICANS CANDIDA species, such CANDIDA GLABRATA, increasing in frequency. Diagnosis of invasive candidiasis is commonly based on blood culture results; however, the sensitivity of blood culture to identify CANDIDA is low. Because early, appropriate therapy has been associated with improved outcomes, antifungal therapy is being implemented in critically ill patients with risk factors for candidemia (prophylaxis). Systemic antifungal therapy is also being utilized in patients at increased risk for invasive candidiasis based on surrogate markers of infection such as colonization (preemptive therapy), or in patients with unresolving sepsis despite appropriate management (empirical therapy). Recent guidelines on the use of antifungal therapy have better identified patients who can be treated with azole derivatives and those who may benefit from echinocandins or polyenes. However, prospective trials are still needed to better identify appropriate therapy for patients at risk for, or with, confirmed invasive CANDIDA infections.

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“…This infection generally occurs among immunocompromised patients and those hospitalized with serious underlying diseases, besides being considered the fourth most frequent cause of bloodstream infections [1,2]. Amphotericin B and azoles are mainly used in clinical conditions; however, the cytotoxicity of these drugs and the resistance of the fungus constitute an important problem.…”

Section: Introductionmentioning

confidence: 99%

Artin M enhances TNF-α production and phagocytosis of Candida albicans mediated by dectin-1 and mannose receptors

Loyola

Custodio

Felipe

et al. 2012

International Immunopharmacology

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The activities of dectin-1 and mannose receptors on phagocytosis of Candida albicans and the production of TNF-α by macrophages from mice pretreated for 3 days with extract of Artocarpus intergrifolia seeds (jack extract), Artin M or jacalin were studied. Macrophages from these mice were coincubated with C. albicans CR15 (yeast), in the presence of mannose (50mM) plus mannan (100 μg) or laminarin (1mg). Phagocytosis was significantly enhanced to 52% in macrophages from mice pretreated intraperitoneally for 3 days with jack extract (500 μg/250 μl PBS). Reduction in phagocytosis from 52% to 34% (P<0.05) occurred in the presence of mannose receptor inhibitors and from 52% to 16% (P<0.01) in the presence of dectin-1 inhibitor laminarin, whereas only 20% of control macrophages phagocytosed blastoconidia. Similar results were verified for pretreatment of mice with Artin M (2.5 μg/250 μl PBS), but not for jacalin (25 μg/250 μl PBS). Macrophages from mice pretreated 3 days previously with jack extract or Artin M and then coincubated for 2h with C. albicans presented a significant increase in TNF-α production, correlating with significantly less transition of yeast to filamentous forms compared to pretreatment with jacalin. These results suggest that Artin M, but not jacalin present in jack extract significantly increased TNF-α production and the activity of mannose and dectin-1 receptors.

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New Approach for Diagnosis of Candidemia Based on Detection of a 65-Kilodalton Antigen

Cited by 18 publications

References 50 publications

Diagnosis and Treatment of Candidemia in the Intensive Care Unit

Diagnosis and Treatment of Candidemia in the Intensive Care Unit

CandidaProphylaxis and Therapy in the ICU

Artin M enhances TNF-α production and phagocytosis of Candida albicans mediated by dectin-1 and mannose receptors

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