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Candida Colonization Index in Patients Admitted to an ICU
Department of Biomedical Science and Human Oncology–Hygiene Section, University of Bari “Aldo Moro”, Piazza G. Cesare no. 11, 70124 Bari, Italy
Department of Emergency and Organ Transplantation-Anaesthesia and Intensive Care Unit, University of Bari “Aldo Moro”, Piazza G. Cesare no. 11, 70124 Bari, Italy
Department of Historical and Geographic Science–Statistic-University of Bari “Aldo Moro”, Piazza Umberto I no. 1, 70124 Bari, Italy
* Author to whom correspondence should be addressed.
Received: 30 August 2011; in revised form: 10 October 2011 / Accepted: 14 October 2011 / Published: 20 October 2011
Abstract: Multiple-site colonization with Candida spp is commonly recognized as a risk factor for invasive fungal infection in critically ill patients. We carried out a study to determine the relationship between Candida colonization and invasive infection in neurological patients admitted to an ICU. At admission (T0) and every three days for two weeks, different samples (pharynx swab, tracheal secretions, stomach contents, etc.) were collected for mycological surveillance. Candida mannan antigen and Candida anti-mannan antibodies were assayed. The Colonization Index (CI) and Corrected Colonization Index were calculated for each time point. Of all patients 70% was already colonized by Candida spp at T0 and six of them had CI ≥0.5. Three patients developed candidemia; they had CI ≥0.5 before infection. Positive values of Candida mannan antigen and anti-mannan antibodies were found only in the patients with candidemia. The sensitivity and specificity of the Candida mannan test were 66.6% and 100%, respectively, while the sensitivity and specificity of the anti-mannan antibody test were 100%. In accordance with other authors, we find the surveillance cultures are useful to monitor the Candida colonization in ICU patients. In addition, the sequential observation of anti-mannan antibodies could contribute to early diagnosis of candidiasis more than Candida mannan antigen in immunocompetent patients.
Keywords: Candida colonization; Colonization index; Candida mannan; Candida anti-mannan antibodies
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Caggiano, G.; Puntillo, F.; Coretti, C.; Giglio, M.; Alicino, I.; Manca, F.; Bruno, F.; Montagna, M.T. Candida Colonization Index in Patients Admitted to an ICU. Int. J. Mol. Sci. 2011, 12, 7038-7047.
Caggiano G, Puntillo F, Coretti C, Giglio M, Alicino I, Manca F, Bruno F, Montagna MT. Candida Colonization Index in Patients Admitted to an ICU. International Journal of Molecular Sciences. 2011; 12(10):7038-7047.
Caggiano, Giuseppina; Puntillo, Filomena; Coretti, Caterina; Giglio, Mariateresa; Alicino, Ilaria; Manca, Fabio; Bruno, Francesco; Montagna, Maria Teresa. 2011. "Candida Colonization Index in Patients Admitted to an ICU." Int. J. Mol. Sci. 12, no. 10: 7038-7047.