Clin. 20), and antibodies against different antigens, including mannan, germ tube-specific antigens, and enolase (3, 5, 8, 12-14, 18), have all been investigated for the serodiagnosis of invasive candidiasis, but none has yet achieved broad validation. In the present study we evaluated the diagnostic potential of a new and commercially available enzyme-linked immunosorbent assay (ELISA) to detect antibodies against enolase for the serodiagnosis of invasive candidiasis. We retrospectively analyzed 98 different adult hematological malignancy or intensive care unit patients at increased risk for invasive candidiasis. Patients were divided into two groups according to their clinical and microbiological Lasofoxifene Tartrate diagnostic data. Group I included 42 patients (224 sera) with invasive candidiasis proved by positive blood culture for spp. or histopathology. The species distribution was as follows: and spp., 2 of 42. Group II was a control group with 56 Lasofoxifene Tartrate different adult patients (214 sera) with no clinical or microbiological evidence of invasive candidiasis. Colonization was established by the presence of positive cultures from mucosal specimens. On the basis of the immune status of the patients, both groups were subdivided into patients with immunodeficiencies caused by therapy or underlying diseases and patients without immunodeficiency. Group I patients were divided into 19 patients with indicators of immunodeficiency (group IA) and 23 immunocompetent patients (group IB). The group II patients were divided into those with indicators of immunodeficiency (group IIA; = 28) and those who were immunocompetent (group IB; = 28). All of the sera were stored at ?20C until use. Antibodies directed to recombinant enolase were detected by the commercial Enolasa ELISA Immunoglobulin G (IgG) kit (Laboratorios Vircell, Granada, Spain), according to the manufacturer’s instructions. Each serum was tested in triplicate. The absorbance at 490 nm was measured in an automated ELISA plate reader (Microplate Autoreader; Bio-Tek Devices). To avoid run-to-run variations, results were expressed as a relative absorbance index calculated by dividing the absorbance of the sample by the absorbance of a research serum. The sensitivity, specificity, and positive and negative predictive values were calculated as explained by Kozinn et al. (7). Mean values of relative absorbance of groups were compared by using the Student test (Microsoft Excel); values of 0.05 were considered statistically significant. Both immunocompetent and immunocompromised patients produced similar amounts of anti-enolase antibodies (the imply F2R relative absorbances the standard deviations were 0.9 0.77 and 0.8 0.65, respectively). The performances of the test were comparable in both groups, and the selected cutoff (mean of the relative absorbance plus three times the standard variance of group 2 sera) allowed differentiation between patients with invasive candidiasis and patients without invasive candidiasis in both groups. The detection of antibodies to the enolase was slightly more sensitive but less specific for the diagnosis of invasive candidiasis in the immunocompetent group of patients than in the immunocompromised group (Table ?(Table1)1) . The sensitivity, specificity, and positive and negative predictive values of the test for the diagnosis of invasive candidiasis in the whole population studied were 81.0, 83.9, 79.1, and 85.5%, respectively (Table ?(Table11). TABLE 1. Diagnostic overall performance of Enolasa ELISA IgG with immunocompetent and immunocompromised patients enolase by the Enolasa ELISA IgG kit anticipated the diagnosis made by blood culture. Interestingly, the detection of antibodies to the enolase anticipated the blood culture for 10 of 17 patients analyzed. Mannan and enolase are probably the most immunogenic antigens of (8). Detection of antibodies against extracts made up of enolase or purified enolase has been investigated to help in the diagnosis of invasive candidiasis, since they elicit strong humoral responses (9, 12, 17, 18). Published reports have shown that detection of antibodies to purified enolase allows the detection of invasive Lasofoxifene Tartrate candidiasis with a sensitivity of 50 to 92.5% and a specificity of 78 to 95% (9, 18). The results offered here confirm these data using recombinant enolase. Since immunocompromised patients have an increased risk for developing invasive candidiasis and they may produce lower antibody titers than immunocompetent patients, we investigated the performance of the test in two patient populations: one immunocompromised and the other immunocompetent. However, the performances of the test were comparable in both patient populations. These results are in agreement with those reported by van Deventer et al. (18), who detected anti-enolase antibodies in both immunocompromised and immunocompetent patients, and Lasofoxifene Tartrate with those reported by our group detecting antibodies to germ tubes in both patient populations (15). In summary,.