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Clinical and Vaccine Immunology, November 2009, p. 1538-1545, Vol. 16, No. 11
1071-412X/09/$08.00+0     doi:10.1128/CVI.00176-09
Copyright © 2009, American Society for Microbiology. All Rights Reserved.

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

Rodrigo Berzaghi,1 Arnaldo Lopes Colombo,2 Antonia Maria de Oliveira Machado,3 and Zoilo Pires de Camargo1*

Department of Microbiology, Immunology and Parasitology,1 Department of Medicine, Infectious Diseases Section,2 Department of Medicine, Central Laboratory, Microbiology Division, Federal University of São Paulo, São Paulo, Brazil3

Received 27 April 2009/ Returned for modification 27 May 2009/ Accepted 16 September 2009

Nosocomial candidiasis is a major concern in tertiary care hospitals worldwide. This infection generally occurs in patients with degenerative and neoplastic diseases and is considered the fourth most frequent cause of bloodstream infections. Diagnosis of candidemia or hematogenous candidiasis has been problematic because clinical signs and symptoms are nonspecific, leading to delays in diagnosis and, consequently, delays in appropriate antifungal therapy. We developed an inhibition enzyme-linked immunosorbent assay (ELISA) for detection of a 65-kDa antigen in an experimental model of candidemia and for diagnosis of patients in intensive care units (ICUs) with suspected candidemia. An anti-65-kDa monoclonal antibody was tested for detection of the 65-kDa antigen produced by Candida albicans, Candida tropicalis, and Candida parapsilosis in murine candidemia models. The 65-kDa antigen was detected in sera at concentrations ranging from 0.012 to 3.25 µg/ml. A total of 20 human patients with candidemia were then evaluated with the inhibition ELISA using sequential sera. Sixteen (80%) patients had the 65-kDa antigen in concentrations ranging from 0.07 to 5.0 µg/ml. Sequential sera from patients with candidemia presented three different patterns of antigenemia of the 65-kDa molecule: (i) total clearance of antigenemia, (ii) initial clearance and relapse of antigenemia, and (iii) partial clearance of antigenemia. Our results indicate detection of the 65-kDa protein may be a valuable tool for the diagnosis of candidemia by C. albicans, C. tropicalis, and C. parapsilosis.

* Corresponding author. Mailing address: Department of Microbiology, Immunology and Parasitology, Federal University of São Paulo, São Paulo, Brazil. Phone: 11 55 11 5576 4523. Fax: 11 55 11 5571 5877. E-mail: zpcamargo{at}unifesp.br

{triangledown} Published ahead of print on 23 September 2009.

Clinical and Vaccine Immunology, November 2009, p. 1538-1545, Vol. 16, No. 11
1071-412X/09/$08.00+0     doi:10.1128/CVI.00176-09
Copyright © 2009, American Society for Microbiology. All Rights Reserved.





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