Association of lectin pathway proteins with intra-abdominal Candida infection in high-risk surgical intensive-care unit patients. A prospective cohort study within the fungal infection network of Switzerland

J Infect. 2016 Mar;72(3):377-85. doi: 10.1016/j.jinf.2015.12.011. Epub 2015 Dec 28.

Abstract

Objectives: Human studies on the role of mannose-binding lectin (MBL) in patients with invasive candidiasis have yielded conflicting results. We investigated the influence of MBL and other lectin pathway proteins on Candida colonization and intra-abdominal candidiasis (IAC) in a cohort of high-risk patients.

Methods: Prospective observational cohort study of 89 high-risk intensive-care unit (ICU) patients. Levels of lectin pathway proteins at study entry and six MBL2 single-nucleotide polymorphisms were analyzed by sandwich-type immunoassays and genotyping, respectively, and correlated with development of heavy Candida colonization (corrected colonization index (CCI) ≥0.4) and occurrence of IAC during a 4-week period.

Results: Within 4 weeks after inclusion a CCI ≥0.4 and IAC was observed in 47% and 38% of patients respectively. Neither serum levels of MBL, ficolin-1, -2, -3, MASP-2 or collectin liver 1 nor MBL2 genotypes were associated with a CCI ≥0.4. Similarly, none of the analyzed proteins was found to be associated with IAC with the exception of lower MBL levels (HR 0.74, p = 0.02) at study entry. However, there was no association of MBL deficiency (<0.5 μg/ml), MBL2 haplo- or genotypes with IAC.

Conclusion: Lectin pathway protein levels and MBL2 genotype investigated in this study were not associated with heavy Candida colonization or IAC in a cohort of high-risk ICU patients.

Keywords: Candida infections; Complement system; Ficolins; Intensive-care unit; Mannose-binding lectin.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Candida / immunology*
  • Candidiasis, Invasive / genetics
  • Candidiasis, Invasive / immunology*
  • Critical Care
  • Female
  • Genetic Predisposition to Disease
  • Humans
  • Intensive Care Units
  • Intraabdominal Infections / genetics
  • Intraabdominal Infections / immunology*
  • Lectins / blood*
  • Lectins / genetics*
  • Male
  • Middle Aged
  • Prospective Studies
  • Switzerland
  • Young Adult

Substances

  • Lectins