Inagaki M
Department of Internal Medicine, Juntendo University School of Medicine.
Kansenshogaku Zasshi. 1992 Mar;66(3):367-75. doi: 10.11150/kansenshogakuzasshi1970.66.367.
In order to compare 4 serological and biochemical diagnostic tests, HA-test (Candida-HA-test), Cand-Tec, D-arabinitol detective test and Fungal Index (F.I.) were carried out in a total of 8 patients with candidemia, 6 were diagnosed to have systemic candidosis and 2 transient fungemia due to colonized catheters. Rabbits were given venous injections of 1.0 x 10(6) CFU (1 ml) of living Candida albicans type A to study the 4 diagnostic methods by sequential blood culture. Prior to clinical administration of antimycotics the diagnostic methods produced almost the same positive ratios. After administration of antimycotics, the HA-test became positive later than Cand-Tec or D-arabinitol because it detected antibodies in the serum, but its conversion to negative also tended to be slightly slower. Accordingly, the HA-test is considered to be useful for retrospective diagnosis of systemic candidosis. In Cand-Tec, D-arabinitol and F.I., the cases where reversion to normal was not achieved soon after therapy were intractable. In one case, the antigen values after therapy were four times as high as prior to treatment. To differentiate the two cases with transient fungemia from those with systemic candidosis HA- and D-arabinitol tests were considered to be superior to Cand-Tec and F.I. In the experiments with rabbits Cand-Tec was, in spite of its being positive in blood culture, always negative.
为比较4种血清学和生化诊断试验,对8例念珠菌血症患者进行了血凝试验(念珠菌血凝试验)、Cand - Tec试验、D - 阿拉伯糖醇检测试验和真菌指数(F.I.)检测,其中6例被诊断为系统性念珠菌病,2例因导管定植出现短暂真菌血症。给家兔静脉注射1.0×10(6)CFU(1ml)活的A型白色念珠菌,通过连续血培养研究这4种诊断方法。在临床使用抗真菌药物之前,这些诊断方法的阳性率几乎相同。使用抗真菌药物后,血凝试验比Cand - Tec试验或D - 阿拉伯糖醇检测试验出现阳性的时间晚,因为它检测的是血清中的抗体,但其转阴趋势也往往稍慢。因此,血凝试验被认为对系统性念珠菌病的回顾性诊断有用。在Cand - Tec试验、D - 阿拉伯糖醇检测试验和真菌指数检测中,治疗后未很快恢复正常的病例病情难治。有1例患者治疗后的抗原值是治疗前的4倍。为区分2例短暂真菌血症患者和系统性念珠菌病患者,血凝试验和D - 阿拉伯糖醇检测试验被认为优于Cand - Tec试验和真菌指数检测。在家兔实验中,尽管Cand - Tec试验在血培养中呈阳性,但它始终呈阴性。