Key words : candidemia, endotoxin, D-arabinitol, Candida antigen, serological examination

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1 Key words : candidemia, endotoxin, D-arabinitol, Candida antigen, serological examination

2 Fig. 1 The value of fungal index and D- arabinitol/creatinine. Fungal index was mesured by Endotoxin D and Endospecy tests. Candida spp. was isolated from blood in these cases ( ), but not isolated in these cases ( œ). * : recurrent case of candidemia. [ ] : normal range. Each value presents the mean } standard deviation. Fungal index D-arabinitol/creatinine

3 Fig. 2 The Cand-Tec and Mannan antigen detection. Candida spp. was isolated from blood in these cases ( ), but not isolated in these cases ( œ). [ ] : normal range. Cand - Tec Mannan Ag. Table 1 Clinical efficacy of 9 cases of candidemia

4 Fig. 3 The change of fungal index and D- arabinitol/creatinine in the cases of candidemia treated with antifungal agents. The case with good clinical efficacy ( ), and poor clinical efficacy ( œ). [ ] : normal range. Each value Fig. 4 The change of Cand-Tec and Mannan antigen in candidemia treated with antifungal agents. The case with good clinical efficacy ( ), and poor clinical efficacy ( œ). [ ]: normal range. presents the mean + standard deviation. Cand - Tec Fungal index D-arabinitol/creatinine Mannan Ag.

5

6 3) Obayashi, T., Tamura, H., Tanaka, S., Ohki, M., Takahashi, S., Araki, M., Matsuda, M. & Kawai, T.: A new chromogenic endotoxinspecific assay using recombined limulus coagu- lation enzyme and its clinical application. Clinica Chemica Acta, 149 : 55-65, ) Dorn, G.L., Land, G.A. & Wilson, G.E. : Im- proved blood culture technique based on centrifugation : Clinical evaluation. J. Clin. Microbiol., 9 : , ) Bille, J., Edson, R.S. & Roberts, G.D. : Clinical evaluation of the lysiscentrifugation blood culture system for the detection of fungemia and comparison with a conventional biphagic broth blood culture system. J. Clin. Microbiol., 19: , Clinical Evaluation of Serological Antigen Detection Tests for Candidemia Shigefumi MAESAKI, Shigeru KOHNO, Hiroshi YAMADA, Kotaro MITSUTAKE, Hidenori SUGIYAMA, Hiroyuki HORI, Mitsuo KAKU, Hironobu KOGA & Kohei HARA 2nd Department of Internal Medicine, School of Medicine, Nagasaki University Makiko SETO & Genichiro MAMEYA Nagasaki-kita Hospital The new serological tests for candidemia were evaluated. In nine cases of candidemia, fungal index (Endotoxin D-Endospecy) was } pg/ml and D-arabinitol/creatinine 1.10 } 1.04 itimol/mg. Fungal index was significantly (p<0.01) higher in candidemia than suspected infections. All candidemia were positive for Cand-Tec latex agglutination, but twelve of the sixteen cases of suspected infections were also positive. Mannan latex agglutination was very specific for candidemia. Four cases of candidemia was positive for Mannan latex agglutination and only one case was positive in suspected infections. Fungal index and D-arabinitol/creatinine was decreased after treatment of antifungal agents. In poor clinical efficacy case, these titer remained high even after treatment data suggested the usefulness of these serological tests for candidemia.. These

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