Comparative evaluation of the Candida agglutinin test, precipitin test, and germ tube dispersion test in the diagnosis of candidiasis

Normal sera and sera from burned patients were examined for Candida agglutinin titers, precipitin titers, and the ability to disperse germ tubes of Candida albicans in an attempt to determine whether germ tube dispersion is correlated with Candida infection as animal models have indicated. Other investigators have reported that immunoglobulin G antibody to Candida interferes with a serum clumping factor resulting in germ tube dispersion. Germ tube dispersion in sera from burned patients with varying degrees of Candida infection is significantly greater than that found in uninfected controls. In addition, the germ tube dispersion test indicated the presence of Candida infection in several patients who had clinical evidence of infection but no detectable agglutinins or precipitins.</jats:p

Biochemical examination of sera during systemic Candida infection in mice

Candida pathogenesis was examined by intravenous challenge of mice with either C. albicans or C. guilliermondii. Animals were moribund 12 h postchallenge with C. albicans and were found to have the greatest number of organisms in the heart and kidney, severe interstitial myocarditis, and elevated serum levels of blood urea nitrogen, creatine phosphokinase, serum glutamic oxalacetic transaminase, serum glutamic pyruvic transaminase, and lactic dehydrogenase. In contrast, challenge with C. guilliermondii resulted in a significantly lower renal census, no myocarditis, and no significant change in the concentration of these serum constituents. Challenge with nonviable C. albicans did not produce the effects observed with viable organisms. Moreover, challenge with filamentous C. albicans resulted in biochemical alterations of lower magnitude and in lower mortality rates. These results indicated that altered serum biochemistries were correlated with the histopathology of fatal Candida infection and that there were distinct differences with C. guilliermondii and the dimorphic phases of C. albicans.</jats:p

Clinical evaluation of the AutoMicrobic system Yeast Biochemical Card for rapid identification of medically important yeasts

The autoMicrobic system Yeast Biochemical Card (Vitek Systems, Inc., subsidiary of McDonnell Douglas, Hazelwood, Mo.), a fully automated and computer-assisted method for identifying seven yeast genera based on 26 biochemical reactions, was compared with the API 20C (Analytab Products, Plainview, N.Y) yeast identification system, using 253 clinical yeast isolates. There was an 84% correlation between the Yeast Biochemical Card and API 20C systems based on biochemical tests alone and a 96% correlation when morphology was combined with the biochemical profile. Of 22 species examined, 14 were definitively identified within 24 h, using only the biochemical tests; the remaining 8 species were presumptively identified, using biochemical tests within 24 h, with definitive identification being completed in 48 to 72 h when morphological characteristics were ascertained. The Yeast Biochemical Card system was both a facile and, with concomitant morphology, an accurate system for performing yeast identification.</jats:p