The Evaluation of Serum Candida mannan antigen as a Marker in Neonatal Sepsis

The present study was designed to evaluate the serum concentration of Candida mannan antigen for detection of neonatal fungal sepsis. Neonates were recruited from neonatal intensive care unit (NICU) of Ain Shams University in the period from October 2011 till April 2012. In this study, Candida mannan Ag was measured in 36 neonates males 16 (44.4%) and females 20 (55.6) diagnosed as having sepsis, and 36 healthy neonates males 19 (53.3%) and females 17 (46.7%) with no clinical signs or laboratory evidence for sepsis serving as a control group. All neonates were subjected to full history taking, thorough clinical examination and measurement of Candida mannan antigen level using ELISA technique. This study showed that there is a high incidence of fungal infection in neonates admitted in NICU as 47.2% of cases had positive Candida mannan Ag. To conclude, this study demonstrated that fungal infection is very common in NICU, long use of antibiotics, long stay in NICU, total parenteral nutrition, mechanical ventilation, and major surgery are risk factors for candidemia. Thrombocytopenia value is the major significant markers of systemic candidiasis. Negative result of the test for the presence of antigen does not exclude IC. A low concentration of rapidly eliminated antigen during the course of infection may show false-negative because of these antigens are present in the blood stream only transiently, and they are eliminated by forming immune complexes as well as via endocytosis by Kupffer cells in the liver. So Regular sampling and monitoring for the presence of mannan in the serum is vital for the patients. Also Parallel monitoring of circulating mannan and antimannan antibodies provided rapid results with high sensitivity (80%) and specificity (93%).