The use of mannan antigen and anti-mannan antibodies in the diagnosis of invasive candidiasis: recommendations from the Third European Conference on Infections in Leukemia.

Details

Ressource 1Download: BIB_059C5E3D1FD5.P001.pdf (1150.43 [Ko])
State: Public
Version: author
Serval ID
serval:BIB_059C5E3D1FD5
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
The use of mannan antigen and anti-mannan antibodies in the diagnosis of invasive candidiasis: recommendations from the Third European Conference on Infections in Leukemia.
Journal
Critical Care
Author(s)
Mikulska M., Calandra T., Sanguinetti M., Poulain D., Viscoli C.
Working group(s)
Third European Conference on Infections in Leukemia Group
Contributor(s)
Akova M., Arendrup M., Barnes R., Bille J., Bretagne S., Calandra T., Castagnola E., Cordonnier C., Cornely OA., Cruciani M., Cuenca-Estrella M., Dannaoui E., De La Camara R., Dellow E., Donnelly P., Drgona L., Einsele H., Engelhard D., Flückiger U., Gachot B., Gonzales-Moreno J., Groll A., Hanel I., Herbrecht R., Heussel CP., Jones B., Kibbler C., Klimko N., Klingspor L., Kouba M., Lamoth F., Lanternier F., Lehrnbecher T., Loeffler J., Lortholary O., Maertens J., Marchetti O., Maschan A., Mikulska M., Pagano L., Petrikos G., Poulain D., Racil Z., Reusser P., Ribaud P., Richardson M., Rizzi-Puechal V., Ruhnke M., Sanguinetti M., Sinko J., Skiada A., Styczynski J., Thiebaut A., Verweij P., Viscoli C., Wahl J., Ward K., White P.
ISSN
1466-609X (Electronic)
ISSN-L
1364-8535
Publication state
Published
Issued date
2010
Volume
14
Number
6
Pages
R222
Language
english
Notes
Publication types: Journal Article ; Review
Publication Status: ppublish
Abstract
INTRODUCTION: Timely diagnosis of invasive candidiasis (IC) remains difficult as the clinical presentation is not specific and blood cultures lack sensitivity and need a long incubation time. Thus, non-culture-based methods for diagnosing IC have been developed. Mannan antigen (Mn) and anti-mannan antibodies (A-Mn) are present in patients with IC. On behalf of the Third European Conference on Infections in Leukemia, the performance of these tests was analysed and reviewed.
METHODS: The literature was searched for studies using the commercially available sandwich enzyme-linked immunosorbent assays (Platelia™, Bio-Rad Laboratories, Marnes-la-Coquette, France) for detecting Mn and A-Mn in serum. The target condition of this review was IC defined according to 2008 European Organization for Research and Treatment of Cancer/Mycoses Study Group criteria. Sensitivity, specificity and diagnostic odds ratios (DOR) were calculated for Mn, A-Mn and combined Mn/A-Mn testing.
RESULTS: Overall, 14 studies that comprised 453 patients and 767 controls were reviewed. The patient populations included in the studies were mainly haematological and cancer cases in seven studies and mainly intensive care unit and surgery cases in the other seven studies. All studies but one were retrospective in design. Mn sensitivity was 58% (95% confidence interval [CI], 53-62); specificity, 93% (95% CI, 91-94) and DOR, 18 (95% CI 12-28). A-Mn sensitivity was 59% (95% CI, 54-65); specificity, 83% (95% CI, 79-97) and DOR, 12 (95% CI 7-21). Combined Mn/A-Mn sensitivity was 83% (95% CI, 79-87); specificity, 86% (95% CI, 82-90) and DOR, 58 (95% CI 27-122). Significant heterogeneity of the studies was detected. The sensitivity of both Mn and A-Mn varied for different Candida species, and it was the highest for C. albicans, followed by C. glabrata and C. tropicalis. In 73% of 45 patients with candidemia, at least one of the serological tests was positive before the culture results, with mean time advantage being 6 days for Mn and 7 days for A-Mn. In 21 patients with hepatosplenic IC, 18 (86%) had Mn or A-Mn positive test results at a median of 16 days before radiological detection of liver or spleen lesions.
CONCLUSIONS: Mn and A-Mn are useful for diagnosis of IC. The performance of combined Mn/A-Mn testing is superior to either Mn or A-Mn testing.
Keywords
Animals, Antibodies, Fungal/biosynthesis, Antigens, Fungal/immunology, Candida/immunology, Candidiasis, Invasive/diagnosis, Candidiasis, Invasive/immunology, Congresses as Topic, Europe, Humans, Leukemia/complications, Leukemia/immunology, Mannans/immunology, Practice Guidelines as Topic/standards, Randomized Controlled Trials as Topic/standards
Pubmed
Web of science
Open Access
Yes
Create date
23/12/2010 15:34
Last modification date
20/08/2019 12:27
Usage data