Evaluation of antibody coating of yeasts in urine as an indicator of the site of urinary tract infection

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Abstract
Antibody coating of yeasts (Candida sp. and Torulopsis sp.) found in urine specimens was investigated to ascertain whether the presence of such coating might identify the site of urinary tract infection. Washed yeast cells obtained by centrifugation of fresh urine specimens were reacted with fluorescein-conjugated goat antihuman immunoglobulins (Ig) G, A, and M and examined by fluorescent microscopy. IgG was found on the surface of all species of yeast encountered in all urine specimens evaluted, whereas there was variability of IgA AND IgM coating. Antibody coating with IgG, IgA, AND IgM was also demonstrated on yeasts from other body sites (sputum, gastrostomy, oral, etc.). Control experiments confirmed the specificity of the reactions. Thus, it appears that yeasts from any body site are coated with antibodies. These results are in contrast to recent work with bacteria which showed that the presence of antibody-coated (IgG) bacteria indicates upper urinary tract infection (pyelonephritis) while bacteria are not coated with antibodies in lower urinary tract infection. Since all yeasts from all body sites tested were found to be coated with antibody regardless of the clinical situation, the presence of surface antibody has no diagnostic value in identifying the site of urinary tract infection with yeasts.