| Objective:The incidence of candidiasis has been increasing in recent years and the mortality rate is high.The mortality of candidiasis is related to the time of antifungal treatment[1],and inappropriate or delayed treatment increases mortality[2].Rapid and accurate diagnosis of candidiasis and effective treatment are the basis of successful cure and mortality reduction.Candidiasis lacks specific symptoms,and the diagnosis of candidiasis has become a major challenge for clinicians.The gold standard for the diagnosis of invasive candidiasis is tissue pathology or aseptic humoral culture,but tissue pathology requires invasive operation with low sensitivity,and the incubation time of aseptic humoral culture is long with low positive rate.Clinicians urgently need to diagnose candidiasis quickly and effectively to guide clinical treatment.The development of colloidal gold immunechromatography,the discovery of candida antigens and antibodies,provides a new way for the detection of candidiasis.Colloidal gold immunechromatography technology was used in this study to detect candida IgM and IgG antibody in the serum samples,and was compared with serum G test and BALF G test,to evaluate the clinical application value of the two kinds of antibodies in the diagnosis of pulmonary candidiasis,and to seek more effective,simple and rapid method in the diagnosis of candidiasis.Method:1.Hospitalized patients with informed consent were selected in ICU and the general ward in department of respiratory and critical care medicine of People's Liberation Army 307 Hospital between September 2017 and March 2018,to draw their blood samples and detect the candida IgM and IgG antibody respectively;According to the patient's condition,the clinician sent blood,sputum and BALF specimen to do culture,smear,G test and GM test.2.The corresponding sensitivity of IgM antibody detection,IgG antibody detection,serum G test and BALF G test were calculated respectively.3.To analyze the application value of IgM antibody and IgG antibody detection for candidiasis.Results:1.76 patients?38 male and 38 female?were screened,the patients of probable diagnosis of which were age 79.5±8.8,31.5±23.2 days of duration of hospitalization,and the patients of no fungal infection group of which were age 69.9±11.9,9.8±4.2 days of duration of hospitalization.2.For the 38 isolates fungus cultivated,there were Candida albicans in 22 isolates,Candida glabrata in 5 isolates,Candida tropicalis in 2 isolates,Candida rugosa in 1isolates,Candida krusei in 1 isolates,Candida parapsilosis in 1 isolates,others in 6isolates.3.All of the 76 patients underwent IgM and IgG antibody detection,33 and 22positive respectively;BALF G test in 35 cases,and 15 were positive;Serum G test in38 cases,and 1 positive;Sputum culture in 65 cases,and 35 positive;BALF culture in35 cases,and 12 positive;Blood culture in 14 cases,and 0 positive.4.With probable diagnosis as the standard,the IgM antibody detection sensitivity was 100%,specificity 64.2%,Youden index 0.642;IgG antibody detection sensitivity was 87.5%,specificity 77.9%,Youden index 0.654;Serum G test sensitivity was 0%,specificity 97.1%,Youden index-0.029;BALF G test sensitivity was 83.3%,specificity 65.4%,Youden index 0.487.Conclusion:1.Patients with pulmonary candidiasis infection have older ages,more basic diseases,long hospital stay and high mortality.2.Candida albicans is the most common pathogenic fungus in this study.3.The positive rate of blood culture which is gold standard was low in the diagnosis of pulmonary candidiasis;4.The diagnostic value of candida IgG antibody in pulmonary candidiasis is higher than that of G test,which is a better diagnostic indicator. |
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