AUTHOR=Koehler Felix C. , Cornely Oliver A. , Wisplinghoff Hilmar , Schauss Astrid C. , Salmanton-Garcia Jon , Ostermann Helmut , Ziegler Maren , Bacher Petra , Scheffold Alexander , Alex Regina , Richter Anne , Koehler Philipp 

TITLE=Candida-Reactive T Cells for the Diagnosis of Invasive Candida Infection—A Prospective Pilot Study

JOURNAL=Frontiers in Microbiology

VOLUME=9

YEAR=2018

URL=https://www.frontiersin.org/journals/microbiology/articles/10.3389/fmicb.2018.01381

DOI=10.3389/fmicb.2018.01381

ISSN=1664-302X

ABSTRACT=<p><bold>Background:</bold> Blood or tissue culture or histology prove invasive <italic>Candida</italic> infection, but long time to result, limited feasibility and sensitivity call for new approaches. In this pilot project, we describe the diagnostic potential of quantitating <italic>Candida</italic>-reactive, CD4/CD69/CD154 positive lymphocytes in blood of patients with invasive <italic>Candida</italic> infection.</p><p><bold>Methods:</bold> We used flow cytometry quantitating <italic>Candida</italic>-reactive, CD4/CD69/CD154 positive lymphocytes from peripheral blood of patients with invasive <italic>Candida</italic> infection, from patients at risk and healthy volunteers as controls.</p><p><bold>Results:</bold> Elevated levels of <italic>Candida</italic>-reactive lymphocytes were measured in 13 patients with proven invasive <italic>Candida</italic> infection and in one patient with probable hepatosplenic candidiasis. Results of three candidemia patients were uninterpretable due to autofluorescence of samples. Twelve of 13 patients had <italic>Candida</italic> identified to species level by conventional methods, and T cell reactivity correctly identified <italic>Candida</italic> species in 10 of 12 patients. Nine hematological high-risk patients and 14 healthy donors had no elevated <italic>Candida</italic>-reactive T cell counts.</p><p><bold>Conclusions:</bold> This <italic>Candida</italic>-reactive lymphocyte assay correctly identified the majority of patients with invasive <italic>Candida</italic> infection and the respective species. Our assay has the potential to support diagnosis of invasive <italic>Candida</italic> infection to species level and to facilitate tailored treatment even when biopsies are contraindicated or cultures remain negative.</p>