Evaluation of different commercial ELISA methods for the serodiagnosis of systemic candidosis

Summary.  Different commercial enzyme‐linked immunsorbent assays (ELISA) were evaluated in a preliminary study for diagnosis of systemic candidosis: Biomerica ® and Virotech GmbH, which allowed immunoglobulin G detection, and Platelia ® , which associated total antibody to antigen detection. They were tested with a home‐made ELISA and compared with the routine techniques used in the hospital laboratory: indirect immunofluorescence and counter‐immunoelectrophoresis. Sera were obtained from patients with probable or proven systemic candidosis (groups 3 and 4, n =8 and n =14, respectively) and from patients without systemic candidosis who were divided into controls ( n =10), those hospitalized without Candida isolation (group 1, n =10) and those hospitalized with Candida isolation in a peripheral site (group 2, n =18). The immunoglobulin G ELISAs showed a higher sensitivity associated with lower specificity compared to the indirect immunofluorescence, counter‐immunoelectrophoresis and total immunoglobulin ELISAs. Mannan antigen detection showed the highest specificity (78.9%). Its association with the detection of total anti‐ Candida immunoglobulins was more sensitive than the association of indirect immunofluorescence with counter‐immunoelectrophoresis (95.4% versus 59%, respectively) with a specificity of 52.6% (versus 55.2%). Interest in the use of commercial ELISAs, more particularly the Platelia ® tests, has to be confirmed in a prospective study with follow‐up of the patients.