The utility of serology in diagnosing candidosis in non‐neutropenic critically ill patients

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Abstract
Summary. This study was carried out to evaluate the utility of serological tests in the diagnosis of candidal infections in non‐neutropenic critically ill patients. A prospective study was carried out in a 10‐bed general intensive care unit; all patients with at least one organic sample with Candida spp. were included. A therapeutic–diagnostic algorithm was designed, and patients were treated or not, according to a classification. Blood samples were taken, and serological tests included: antigenaemia detection using two different commercial latex kits (Cand‐Tec® and Pastorex®) and antibody detection by indirect haemagglutination (IHA) and indirect germ tube immunofluorescence (IFA). A total of 56% of antibody tests (IHA 45% and IFA 64%) and 26% of antigen tests (Cand‐Tec 36% and Pastorex 17%) were positive. The sensitivity and specificity of these tests with respect to systemic candidosis were 37% and 78%, respectively, for antibodies, and 0% and 90% for antigens. There was statistical significance for mortality and low levels of antibodies; Candida glabrata was detected by IFA and Candida tropicalis by Cand‐Tec. Serological tests may help to define the prognosis of these patients and to support the detection of specific Candida species.