Parra-Sánchez Manuel, Zakariya-Yousef Breval Ismail, Castro Méndez Carmen, García-Rey Silvia, Loza Vazquez Ana, Úbeda Iglesias Alejandro, Macías Guerrero Desiree, Romero Mejías Ana, León Gil Cristobal, Martín-Mazuelos Estrella
Unit of Infectious Disease and Clinical Microbiology, Hospital Universitario de Valme, Seville, Spain.
Critical Intensive Unit, Hospital Universitario de Valme, Seville, Spain.
Mycopathologia. 2017 Aug;182(7-8):645-652. doi: 10.1007/s11046-017-0125-9. Epub 2017 Apr 4.
Testing for Candida albicans germ-tube antibody IFA IgG assay (CAGTA) is used to detect invasive candidiasis infection. However, most suitable assays lack automation and rapid single-sample testing. The CAGTA assay was adapted in an automatic monotest system (invasive candidiasis [CAGTA] VirClia IgG monotest (VirClia), a chemiluminescence assay with ready-to-use reagents that provides a rapid objective result. CAGTA assay was compared with the monotest automatic VirClia assay in order to establish the diagnostic reliability, accuracy, and usefulness of this method. A prospective study with 361 samples from 179 non-neutropenic critically ill adults patients was conducted, including 21 patients with candidemia, 18 with intra-abdominal candidiasis, 84 with Candida spp. colonization, and 56 with culture-negative samples, as well as samples from ten healthy subjects. Overall agreement between the two assays (CAGTA and VirCLIA) was 85.3%. These assays were compared with the gold-standard method to determine the sensitivity, specificity as well as positive and negative predictive values. In patients with candidemia, values for CAGTA and VirCLIA assays were 76.2 versus 85.7%, 80.3 versus 75.8%, 55.2 versus 52.9%, and 91.4 versus 94.3%, respectively. The corresponding values in patients with intra-abdominal candidiasis were 61.1 versus 66.7%, 80.3 versus 75.8%, 45.8 versus 42.9%, and 88.3 versus 89.3%, respectively. No differences were found according to the species of Candida isolated in culture, except for Candida albicans and C. parapsilosis, for which VirClia was better than CAGTA. According to these results, the automated VirClia assay was a reliable, rapid, and very easy to perform technique as tool for the diagnosis invasive candidiasis.
检测白色念珠菌芽管抗体间接荧光免疫法IgG检测（CAGTA）用于检测侵袭性念珠菌感染。然而，大多数合适的检测方法缺乏自动化和快速单样本检测。CAGTA检测在自动单样本检测系统中进行了改进（侵袭性念珠菌病[CAGTA]VirClia IgG单样本检测（VirClia），一种使用即用型试剂的化学发光检测方法，可提供快速客观的结果。将CAGTA检测与单样本自动VirClia检测进行比较，以确定该方法的诊断可靠性、准确性和实用性。对179例非中性粒细胞减少的危重症成年患者的361份样本进行了前瞻性研究，其中包括21例念珠菌血症患者、18例腹腔念珠菌病患者、84例念珠菌属定植患者、56例培养阴性样本患者以及10名健康受试者的样本。两种检测方法（CAGTA和VirCLIA）的总体一致性为85.3%。将这些检测方法与金标准方法进行比较，以确定敏感性、特异性以及阳性和阴性预测值。在念珠菌血症患者中，CAGTA和VirCLIA检测的值分别为76.2%对85.7%、80.3%对75.8%、55.2%对52.9%和91.4%对94.3%。腹腔念珠菌病患者的相应值分别为61.1%对66.7%、80.3%对75.8%、45.8%对42.9%和88.3%对89.3%。除白色念珠菌和近平滑念珠菌外，根据培养分离出念珠菌的种类未发现差异，对于这两种念珠菌，VirClia检测优于CAGTA检测。根据这些结果来看，自动化的VirClia检测作为诊断侵袭性念珠菌病的工具，是一种可靠、快速且非常易于操作的技术。
