Evidence map›Paper›PMID 21143834›Full record

ReviewCritical care (London, England)2010

The use of mannan antigen and anti-mannan antibodies in the diagnosis of invasive candidiasis: recommendations from the Third European Conference on Infections in Leukemia.

Malgorzata Mikulska, Thierry Calandra, Maurizio Sanguinetti, Daniel Poulain, Claudio Viscoli, Third European Conference on Infections in Leukemia Group

Open access · goldAbstract readReview
In one paragraph

Review in Critical care (London, England), 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 120 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
120citing papers in PubMed, 7 pooled it
8.3field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

120 citing papers in PubMed, 7 syntheses or guidelines pooled it, 313 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Clinical Practice Guideline for the Management of Candidiasis: 2016 Update by the Infectious Diseases Society of America.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2016
    Guideline
  5. Pooled it
  6. Guideline
  7. Guideline
  8. Diagnostic performance of β-(1→3)-D-glucan, twoJournal of clinical microbiology · 2026
    Trial
  9. A Synthetic β-Mannan Epitope Enables Immunization and Detection of Candida auris.Angewandte Chemie (International ed. in English) · 2026
    Article
  10. Review
  11. Review
  12. Review
  13. Review
  14. Review
  15. Article
  16. Glycan microarray analysis ofProceedings of the National Academy of Sciences of the United States of America · 2025
    Article
  17. Changing Climate, ChangingJournal of fungi (Basel, Switzerland) · 2025
    Review
  18. Article
  19. Diagnostic Approaches forMicroorganisms · 2025
    Review
  20. Early-Onset Candidemia in Adult Intensive Care Units.Diagnostics (Basel, Switzerland) · 2025
    Review

60 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 5 institutions in 4 countries.

Malgorzata MikulskaDivision of Infectious Diseases, San Martino University Hospital, L,go R, Benzi, 10, Genoa, Italy. m_mikulska@yahoo.com
Thierry Calandra
Maurizio Sanguinetti
Daniel Poulain
Claudio Viscoli
Third European Conference on Infections in Leukemia Group
Inserm · FRMartin University · USUniversità Cattolica del Sacro Cuore · ITUniversity of Genoa · ITUniversity of Lausanne · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionTimely diagnosis of invasive candidiasis (IC) remains difficult as the clinical presentation is not specific and blood cultures lack sensitivity and need a long incubation time. Thus, non-culture-based methods for diagnosing IC have been developed. Mannan antigen (Mn) and anti-mannan antibodies (A-Mn) are present in patients with IC. On behalf of the Third European Conference on Infections in Leukemia, the performance of these tests was analysed and reviewed.

methodsThe literature was searched for studies using the commercially available sandwich enzyme-linked immunosorbent assays (Platelia™, Bio-Rad Laboratories, Marnes-la-Coquette, France) for detecting Mn and A-Mn in serum. The target condition of this review was IC defined according to 2008 European Organization for Research and Treatment of Cancer/Mycoses Study Group criteria. Sensitivity, specificity and diagnostic odds ratios (DOR) were calculated for Mn, A-Mn and combined Mn/A-Mn testing.

resultsOverall, 14 studies that comprised 453 patients and 767 controls were reviewed. The patient populations included in the studies were mainly haematological and cancer cases in seven studies and mainly intensive care unit and surgery cases in the other seven studies. All studies but one were retrospective in design. Mn sensitivity was 58% (95% confidence interval [CI], 53-62); specificity, 93% (95% CI, 91-94) and DOR, 18 (95% CI 12-28). A-Mn sensitivity was 59% (95% CI, 54-65); specificity, 83% (95% CI, 79-97) and DOR, 12 (95% CI 7-21). Combined Mn/A-Mn sensitivity was 83% (95% CI, 79-87); specificity, 86% (95% CI, 82-90) and DOR, 58 (95% CI 27-122). Significant heterogeneity of the studies was detected. The sensitivity of both Mn and A-Mn varied for different Candida species, and it was the highest for C. albicans, followed by C. glabrata and C. tropicalis. In 73% of 45 patients with candidemia, at least one of the serological tests was positive before the culture results, with mean time advantage being 6 days for Mn and 7 days for A-Mn. In 21 patients with hepatosplenic IC, 18 (86%) had Mn or A-Mn positive test results at a median of 16 days before radiological detection of liver or spleen lesions.

conclusionsMn and A-Mn are useful for diagnosis of IC. The performance of combined Mn/A-Mn testing is superior to either Mn or A-Mn testing.

Indexed as

Congresses as TopicAnimalsAntibodies, FungalAntigens, FungalCandidaCandidiasis, InvasiveEuropeHumansLeukemiaMannansPractice Guidelines as TopicRandomized Controlled Trials as TopicAntibodies, FungalAntigens, FungalMannans

Identifiers

PMID21143834
PMCPMC3219989
OpenAlexW2141329212

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.