Diagnosis and monitoring of disseminated candidiasis based on serum/urine D/L‐arabinitol ratios

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Abstract

Disseminated candidiasis, a devastating disease with high morbidity and mortality in immunosuppressed patients, is difficult to diagnose because of the protean nature of symptoms and the lack of rapid and reliable laboratory diagnostic procedures. The subject of this review is the status of gas chromatographic–mass spectrometric techniques for the determination of D‐arabitinol, a unique metabolite of pathogenic Candida species, in serum and urine. The enantiomers are separated by chiral chromatography followed by specific and sensitive detection using chemical ionization and selected ion monitoring. Using D/L‐arabinitol ratios, instead of individual concentrations, eliminates the need for knowing the volume of samples and for calibration curves. A new filter paper technique requires only an unmeasured drop of whole blood (venous or finger/heel puncture) or urine; paper spots are mailable. Parallel determinations of D/L‐arabinitol ratios in serum and urine in normal subjects and cancer patients with both normal and increased D/L‐arabitinol ratios revealed constant (1.2–1.3 range) ratios of serum D/L‐arabitinol/urine D/L‐arabinitol for all populations studied. Analyzing two body fluids taken at the same time increases reliability by reducing false positives. © 1994 Wiley‐Liss, Inc.

Original languageEnglish
Pages (from-to)51-57
Number of pages7
JournalChirality
Volume6
Issue number2
DOIs
StatePublished - 1994

Keywords

  • arabinitol enantiomers
  • chiral separation
  • diagnosis/monitoring
  • disseminated candidiasis
  • gas chromatography‐mass spectrometry

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