DETERMINATION OF D/L-ARABINITOL RATIO, PRESENCE OF FUNGAL DNA AND PROCALCITONIN LEVELS AS MARKERS FOR CANDIDIASIS IN PREMATURE INFANTS

It is considered that premature infants in invasive of methods treatment condition are a considerable risk group for fungal infection, particularly for opportunistic microorganisms (C. albicans constitutes 50–80%), due to immune system immaturity. The essential problem of the efficacious treatment for candidiasis is lack of sensitive and fast diagnostic methods. d-arabinitol, a characteristic metabolite of several Candida sp. is applied as an alternative non-invasive, diagnostics biomarker for candidiasis. The study group (A) encompassed 51 premature infants, born 24–36 Hbd, suspected of fungal infection (mothers had vaginal fungal infections). The control group had: (C1), 49 premature infants (born 26–30 Hbd) with birth weights, mean±SD = 1036.74±298.56 g and (C2), 45 premature infants (born 31–35 Hbd) with birth weights, mean±SD = 1904.18±405.67 g. Urinary d/l-arabinitol ratio was determined by GC-ECD methods. Molecular analysis for presence of fungal DNA was made by PCR. Serum procalcitonin levels was performed with LUMI test PCT. In the control groups C1 and C2, d/l-arabinitol ratio was, mean±SD = 2.14±0.54 and 2.16±0.53 respectively. The cut off value was d/l-arabinitol = 3.8. In the study group A there were applied methods (d/l-arabinitol, PCR, procalcitonin) but non-confirmed fungal infection (vs control group p>0.5). In 49 infants d/l-arabinitol ratio, procalcitonin levels were at normal values, results of molecular analysis of DNA did not indicate the presence of Candida sp. Two children with superficial colonization (C. albicans) had a d/l-arabinitol ratio in range of the cut off value limit.