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J Med Microbiol 55 (2006), 537-543; DOI: 10.1099/jmm.0.46314-0
© 2006 Society for General Microbiology
ISSN 1473-5644

Evaluation of a newly developed down-flow immunoassay for detection of serum mannan antigens in patients with candidaemia

Shin-ichi Fujita1,2, Toshiharu Takamura2, Mikio Nagahara2 and Takuma Hashimoto1

Department of Laboratory Medicine, Graduate School of Medical Science1 and Department of Clinical Laboratory Science2 , Kanazawa University Hospital, School of Medicine, Kanazawa University, 13-1 Takara-machi, Kanazawa 920-8640, Japan

Correspondence
Shin-ichi Fujita
fujita-knz{at}umin.ac.jp

Received 2 September 2005
Accepted 12 January 2006

A down-flow immunoassay has been developed to detect serum mannan antigens, and the test was recently marketed as the Unimedi Candida monotest. Using 251 serum samples from 105 patients with candidaemia, a comparison of the Unimedi Candida monotest with the Cand-Tec latex agglutination test and 2 microplate enzyme immunoassay tests (Platelia Candida Ag test and Unimedi Candida) was conducted. One hundred and seventy-five febrile patients without clinical and microbiological evidence of fungal infections and pneumocytosis were examined as controls. The Cand-Tec test had a sensitivity of 38 % and a specificity of 82 %. The sensitivity and specificity of the Platelia Candida Ag test, the Unimedi Candida and the Unimedi Candida monotest were 53 and 92 %, 69 and 89 % and 82 and 96 %, respectively. The sensitivity of the Unimedi Candida monotest was significantly (P<0·01) higher than that of the Plateria Candida Ag test for diagnosing candidaemia caused by Candida parapsilosis. The ß-D-glucan assay had a high sensitivity of 95 %, with a specificity of 84 %. Of 74 patients with candidaemia whose sera were available before or on positive blood culture sampling, 29 (39 %), 38 (51 %) and 48 (65 %) patients had antigenemia detected using the Platelia Candida Ag test, the Unimedi Candida and the Unimedi Candida monotest, respectively. The Unimedi Candida monotest seems to be a promising tool for the early diagnosis of invasive candidiasis, because the test was sensitive, simple, rapid (approx. 1 h) and cost-effective.

Abbreviations: BG, (1->3)-ß-D-glucan.






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