Early Diagnosis of Invasive Candidiasis and Rapid Evaluation of Antifungal Therapy by Combined Use of Conventional Chromogenic Limulus Test and a Newly Developed Endotoxin Specific Assay
作者:
KEIICHI IKEGAMI,
KATSUMI IKEMURA,
TAKESHI SHIMAZU,
MASANORI SHIBUYA,
HISASHI SUGIMOTO,
TOSHIHARU YOSHIOKA,
TSUYOSHI SUGIMOTO,
期刊:
The Journal of Trauma: Injury, Infection, and Critical Care
(OVID Available online 1988)
卷期:
Volume 28,
issue 8
页码: 1118-1126
ISSN:0022-5282
年代: 1988
出版商: OVID
数据来源: OVID
摘要:
Since /9-1,3-glucan is a common component of fungal cell wall, its detection might be useful in diagnosing invasive candidiasis. Not only endotoxin but /3-1,3-glucan activates proclotting enzyme contained in a conventional chromogenic limulus test (CCLT). Endotoxin activates this enzyme through factor C, while the /3-1,3-glucan activates through factor G. Since endotoxin specific test (EST) contains factor C, endotoxin would be quantified. By subtracting EST value from CCLT value, β-1,3-glucan would be quantified. We named this value Fungal Index (FI), and examined if it actually reflects the candidal infection. Ninety-two patients were tested for CCLT and EST prospectively. FI increased significantly in candidal infection (p<0.05) but remained low in GNR infection. Moreover, FI increased proportionally to the severity of candidal infection. Elevated FI decreased when antifungal therapy was successful. Thus FI was a useful index not only in the diagnosis of invasive candidiasis but also in the evaluation of antifungal therapy.
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