Candiduria in non-neutropenic critically-ill surgical patients. Detection of IgA, IgG and IgM antibodies to Candida albicans by germ tube immunofluorescence

The significance of indirect immunofluorescence using Candida albicans germ tube as well as blastospore antigens in the diagnosis of isolated candiduria in non-neutropenic, critically ill surgical patients was assessed. Ten patients with isolated candiduria, 12 with systemic candidosis and 10 with multifocal muco-cutaneous candidosis were included in the study. The sera of another 10 critically-ill patients with no signs of candidosis served as controls. The patients' sera were tested for IgG, ISA and IgM antibodies. The results obtained confirmed indirect germ tube that immunofluorescence is a useful procedure for differentiating systemic candidosis from colonisation of the urinary tract. Indirect immunofluorescence with blastospores? although more sensitive than germ tube immunofluorescence, cannot distinguish muco-cutaneous candidosis from systemic candidosis. Therefore, indirect germ tube immunofluorescence is regarded a useful complementary test to evaluate candiduria in nonneutropenic, HIV-negative, critically ill patients.