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Non-value of antigen detection immunoassays for diagnosis of candidemia
40 Infectious Diseases Newsletter 10(5) May 1991 C O M M E N T S ON CURRENT PUBLICATIONS
Phillips P, Arden D, Radigan G: Non-value of antigen detection immunoassays for diagnosis of candidemia. J Clin Microbiol 28:2320-2326, 1990. This study evaluated the Cand-Tec (Ramco Laboratories, I c., Houston, Tex.) and LA-Candida antigen detection system (Immuno-Mycologics, Inc., Norman, OK) tests for the rapid identification of patients with candidemia. Tests were performed on sera from 33 patients with candidemia, 82 patients with fever and risk factors for invasive candidiasis, and 13 healthy controls. All 106 tests performed with the LA-Candida antigen detection system were negative. The Cand-Tec for a threshold positive titer of/> 1:4 had a sensitivity of 439% and a specificity of 43%.
results, the LA-Candida antigen detection system assay is not useful. The Cand-Tec is more useful although not as useful as previously reported. However, a definitive study in patients with demonstrated invasive candidiasis remains to be done. It is this group that proves the most difficult to diagnose as many are not candidemic. Further work on Cand-Tec and additional methods are needed to reliably diagnose invasive candidiasis. CWS []
Sinnott JT, Cancio MR, Frankle MA, Gustke R, Spiegel PG: Tuberculosis
osteomyelitis masked by concomitant staphyiococcalinfection. Arch Intern Med 150:1865-1867, 1900.
Comment This study found that the Cand-Tec was not particularly useful for the detection of candidemia (33 patients) or for the detection of invasive candidiasis (9 patients). There is a great deal of controversy over Candida antigen tests. Clearly, with no positive
This study used a systematic bone protocol that included mycobacterial culture over a 14-month period to evaluate patients with chronic osteomyelitis. On examination of 140 bone specimens, 4 patients were found with unsuspected tuberculous
osteomyelitis. Each was culture positive for M. tuberculosis, one also showed granulomas by histological examination. The authors conclude that cryptic tuberculous osteomyelitis can contribute to an infection in association with, and masked by, a concomitant staphylococcal process.
Comment Acute staphylococcal osteomyelitis is somewhat unusual in adults. This study by Dr. Sinnott and colleagues demonstrates that one possible predisposing factor may be occult tuberculous infection of the bone. Adherence to a strict protocol developed by Dr. Sirmott allowed these occult cases of tuberculous osteomyelitis to be diagnosed. Microbiology laboratories should incorporate mycobacterial cultures into their bone culture protocol regardless of what the gramstain or routine cultures demonstrate. CWS []
Aims and Scope
General Information
The Infectious Diseases Newsletter seeks to provide concise reports of the current state of knowledge and practice in infectious diseases. Diverse sources are tapped, the primary consideration being the relevance of the information that is gained. The intended audience includes physicians, nurses, and laboratory personnel who participate in the diagnosis, treatment, and prevention of infectious diseases. Such broad dissemination is warranted by the essential, yet interdependent, nature of the efforts of those health care providers whose concern is patients with infectious diseases.
Infectious Diseases Newsletter is published monthly by Elsevier Science Publishing Co., Inc., 655 Avenue of the Americas, New York, New York 10010. Please see inside front cover for subscription information. This newsletter has been registered with the Copyright Clearance Center Inc. Consent is given for copying of articles for personal or internal use, or for the personal or internal use of specific clients. This consent is given on the condition that the copier pay through the Cen~r the per-page fee stated in the code on each page for copying beyond that permitted by the US Copyright Law. If no code appears on an article, the author has not given broad consent to copy and permission to copy must be obtained directly from the author. This consent does not extend to other kinds of copying, such as for general distribution, resale, advertising and promotional purposes, or for creating new collective works. Address orders, changes of address, and claims for missing issues to Journals Fulfillment Department, Elsevier Science Publishing Co., Inc., 655 Avenue of the Americas, New York, New York 10010. Claims for missing issues can be honored only up to three months for domestic addresses and six months for foreign addresses. Duplicate copies will not be sent to replace those undelivered because of failure to notify Elsevier of change of address. Address editorial correspondence to Charles W. Stratton, MD, Director of Clinical Microbiology, Department of Pathology, Vanderbilt University Medical Center, C3321 Medical Center North, Nashville, TN 37232.
Infectious Diseases Newsletter is included in BIOSIS. © 1991 Elsevier Science Publishing Co., Inc. 0278-2316/91/$0.00 + 2.20
Phillips P, Arden D, Radigan G: Non-value of antigen detection immunoassays for diagnosis of candidemia. J Clin Microbiol 28:2320-2326, 1990. This study evaluated the Cand-Tec (Ramco Laboratories, I c., Houston, Tex.) and LA-Candida antigen detection system (Immuno-Mycologics, Inc., Norman, OK) tests for the rapid identification of patients with candidemia. Tests were performed on sera from 33 patients with candidemia, 82 patients with fever and risk factors for invasive candidiasis, and 13 healthy controls. All 106 tests performed with the LA-Candida antigen detection system were negative. The Cand-Tec for a threshold positive titer of/> 1:4 had a sensitivity of 439% and a specificity of 43%.
results, the LA-Candida antigen detection system assay is not useful. The Cand-Tec is more useful although not as useful as previously reported. However, a definitive study in patients with demonstrated invasive candidiasis remains to be done. It is this group that proves the most difficult to diagnose as many are not candidemic. Further work on Cand-Tec and additional methods are needed to reliably diagnose invasive candidiasis. CWS []
Sinnott JT, Cancio MR, Frankle MA, Gustke R, Spiegel PG: Tuberculosis
osteomyelitis masked by concomitant staphyiococcalinfection. Arch Intern Med 150:1865-1867, 1900.
Comment This study found that the Cand-Tec was not particularly useful for the detection of candidemia (33 patients) or for the detection of invasive candidiasis (9 patients). There is a great deal of controversy over Candida antigen tests. Clearly, with no positive
This study used a systematic bone protocol that included mycobacterial culture over a 14-month period to evaluate patients with chronic osteomyelitis. On examination of 140 bone specimens, 4 patients were found with unsuspected tuberculous
osteomyelitis. Each was culture positive for M. tuberculosis, one also showed granulomas by histological examination. The authors conclude that cryptic tuberculous osteomyelitis can contribute to an infection in association with, and masked by, a concomitant staphylococcal process.
Comment Acute staphylococcal osteomyelitis is somewhat unusual in adults. This study by Dr. Sinnott and colleagues demonstrates that one possible predisposing factor may be occult tuberculous infection of the bone. Adherence to a strict protocol developed by Dr. Sirmott allowed these occult cases of tuberculous osteomyelitis to be diagnosed. Microbiology laboratories should incorporate mycobacterial cultures into their bone culture protocol regardless of what the gramstain or routine cultures demonstrate. CWS []
Aims and Scope
General Information
The Infectious Diseases Newsletter seeks to provide concise reports of the current state of knowledge and practice in infectious diseases. Diverse sources are tapped, the primary consideration being the relevance of the information that is gained. The intended audience includes physicians, nurses, and laboratory personnel who participate in the diagnosis, treatment, and prevention of infectious diseases. Such broad dissemination is warranted by the essential, yet interdependent, nature of the efforts of those health care providers whose concern is patients with infectious diseases.
Infectious Diseases Newsletter is published monthly by Elsevier Science Publishing Co., Inc., 655 Avenue of the Americas, New York, New York 10010. Please see inside front cover for subscription information. This newsletter has been registered with the Copyright Clearance Center Inc. Consent is given for copying of articles for personal or internal use, or for the personal or internal use of specific clients. This consent is given on the condition that the copier pay through the Cen~r the per-page fee stated in the code on each page for copying beyond that permitted by the US Copyright Law. If no code appears on an article, the author has not given broad consent to copy and permission to copy must be obtained directly from the author. This consent does not extend to other kinds of copying, such as for general distribution, resale, advertising and promotional purposes, or for creating new collective works. Address orders, changes of address, and claims for missing issues to Journals Fulfillment Department, Elsevier Science Publishing Co., Inc., 655 Avenue of the Americas, New York, New York 10010. Claims for missing issues can be honored only up to three months for domestic addresses and six months for foreign addresses. Duplicate copies will not be sent to replace those undelivered because of failure to notify Elsevier of change of address. Address editorial correspondence to Charles W. Stratton, MD, Director of Clinical Microbiology, Department of Pathology, Vanderbilt University Medical Center, C3321 Medical Center North, Nashville, TN 37232.
Infectious Diseases Newsletter is included in BIOSIS. © 1991 Elsevier Science Publishing Co., Inc. 0278-2316/91/$0.00 + 2.20