The prognostic and diagnostic markers of invasive candidiasis in patients during chemotherapy.

The aim of the work was the early detection of Candida spp. in clinical samples of patients with carcinoma ovariorum undergoing chemotherapy by comparing three indicators of candidiasis: presence of mannan and yeast DNA in the bloodstream and colonization of mucosal membranes by Candida species as a prognostic marker of deep candidiasis. Thirty-one women with carcinoma ovariorum, during chemotherapy without symptoms of deep fungal infections, were examined twice over a six-day period. C. albicans was the dominant organism isolated from mucosal membranes. Two serum samples were positive for mannan on the first day of examination. All these patients were previously colonized by Candida spp. on mucous membranes. Four patients were positive on the last day of examination. Three of these patients were colonized by Candida spp. C. albicans infection was detected early in 4 out of 12 clinical samples by a combination of PCR and mannan-detecting methods. Colonization increases the risk of deep candidiasis. PCR and antigen detection are fast and reliable methods for early detection of Candida in bloodstream. For patients at risk, the clinical samples must be tested by at least two independent methods.