Serological diagnosis of infection of the urinary tract by yeasts

[Aspergillus fumigatus and Candida albicans in cystic fibrosis: clinical significance and specific immune response involving serum immunoglobulins G, A, and M]

OBJECTIVE

The aim of this study was to analyze the clinical significance of Aspergillus fumigatus and Candida albicans in respiratory secretions from patients with cystic fibrosis and to assess the immune response to these fungi in serum.

PATIENTS AND METHODS

The study included 66 patients with cystic fibrosis (34 men; mean age, 16.2 years). Sera from 15 healthy individuals were used as controls.

RESULTS

The serum concentrations of immunoglobulin (Ig) G, IgA, and IgM against A fumigatus and C albicans were higher in patients than in the control group. There was no correlation between the presence of A fumigatus in respiratory secretions and the immune response to the fungus measured in serum. In contrast, the presence of C albicans in respiratory secretions was correlated with the immune response to that fungus. The likelihood of obtaining A fumigatus cultures from respiratory secretions increased with age. The presence of these fungi in respiratory samples was not a risk factor for greater respiratory impairment.

CONCLUSIONS

In response to increased colonization of the lower respiratory tract by A fumigatus and C albicans, patients with cystic fibrosis have elevated serum levels of IgG, IgA, and IgM against those fungi. In patients with cystic fibrosis, culture of sputum and oropharyngeal secretions is adequate for the assessment of lower respiratory tract colonization by C albicans but not A fumigatus. Fungal colonization of the lower respiratory tract is not a risk factor for greater respiratory impairment in patients with cystic fibrosis.

Ureteral blockage by Candida in a patient with urinary derivation type Camey

A study of ureteral blockage by Candida in a patient suffering from urinary derivation is presented. It has been favourably resolved by medical treatment and nephrostomy. The increasing medical importance of urinary infections by fungi, especially in weak patients and catheter carriers, makes it important to employ more aggressive treatment. Regarding urinary derivation and Candida infection, in the case of urinary blockage the possibility must be considered that blockage may be due to fungi, since it can be successfully treated medically without the need of surgery.

A modified cytoplasmic antigen of Candida albicans for serodiagnosis of systemic candidiasis

A modified cytoplasmic antigen, prepared by Natamycin degradation of Candida albicans cells is described. The reactivity of this antigen in detecting precipitins to Candida albicans proved tobe very similar qualitatively and quantitatively to a standardised reference antigen, prepared by X-press disruption when both were compared by immunological techniques; the majority of antigenic components in each proving to be identical. When tested against 127 human sera of unknown antibody content the two antigens showed 100% correlation by counterimmunoelectrophoresis and 87.5% correlation by double diffusion. The modified antigen proved to be reproducible and reliable in use and is easily prepared in the routine laboratory.

Antibodies to Candida species after operations on the large intestine: observations on the association with oral and faecal yeast colonization

The occurrence of agglutinating and precipitating antibodies to Candida species was determined in 50 patients undergoing operations on the large intestine. The number of patients with oral or faecal yeast colonization and the amount of faecal colonization increased during the period after operation. No patient developed overt fungal infection but 15 patients developed precipitins to mannan antigens and 9 patients developed percipitins to cytoplasmic antigens during this period. The association between the formation of precipitins and the extent of faecal colonization is discussed.