Clinical significance of measurement of serum D-arabinitol levels in candiduria patients.

D-Arabinitol, a major candidal metabolite, is reported to be a useful parameter to diagnose disseminated candidiasis. Conventional determination of serum D-arabinitol levels using gas-liquid chromatography is complicated and time-consuming compared with the enzymatic fluorometric assay, newly available in kits. D-Arabinitol concentrations were determined by both enzymatic fluorometric assay kits and gas-liquid chromatography, and a significant correlation (r = 0.943, p less than 0.01) was found between the two methods in 25 sera from 15 patients with candiduria. D-Arabinitol/creatinine ratios were determined using the enzymatic fluorometric assay in 39 candiduria patients (21 febrile and 18 afebrile) and 22 patients without candiduria as the control. The ratios in the febrile patients were significantly greater than those in the afebrile and the nondocumented candidiasis groups. These results suggest that knowledge of the serum D-arabinitol concentration may help to promptly diagnose invasive candidiasis, particularly Candida pyelonephritis. In addition, enzymatic fluorometric assay kits are considered to be advantageous in that they require little time and are simple to use, as compared with gas-liquid chromatography.