[Gas chromatography in express diagnosis of candidiasis and monitoring of antifungal therapy efficacy by D-arabinitol and mannose levels in pediatric patients].

Seventy three children (40 blood and 43 liquor specimens) were examined with the use of gas chromatography (GC) to detect background concentrations of Candida metabolites. The criterium of the children enrollment to the control group was the absence of the clinical and laboratory signs of the fungal infection. The normal contents of the fungus metabolites were considered to be 0.51 +/- 0.28 microgram/ml for D-arabinitol and 17.7 +/- 10.4 micrograms/ml for mannose in the serum and 7.24 +/- 3.04 micrograms/ml for D-arabinitol and 67.1 +/- 47.4 micrograms/ml for mannose in the liquor. Fifty four children at the age of 1 month to 12 years with the signs of the fungal infection requiring systemic antifungal therapy were also examined. Prior to the use of antifungal drugs the routine microbiological tests and GC detection of the fungus metabolites were performed. The fungus was isolated with the cultural method from the blood in 2 patients (6.3 per cent), from the mucosa in 25 (71.4 per cent) out of 32 patients with fungal complications at the background of cytostatic therapy and neutropenia, from the liquor in 3 (21.4 per cent) out of 14 patients with meningitis and from the urine in 8 (100 per cent) out of 8 patients with urinary infection. The GC examination revealed increased levels of the Candida metabolites in 96 per cent of the children. A favourable time course of the infection at the background of amphotericin B or fluconasol use was recorded by the clinical indices which correlated with a reliable decrease of the contents of D-arabinitol and mannose to the normal. The use of GC is recommended in express diagnosis of candidiasis especially when the results of the cultural tests are negative as well as in monitoring of the fungal therapy efficacy.