Disseminated candidiasis: a comparison of two immunologic techniques in the diagnosis.

J. F. Fisher, R. C. Trincher, J. F. Agel, T. B. Buxton, C. A. Walker, D. H. Johnson, R. E. Cormier, W. H. Chew, J. P. Rissing

Research output: Contribution to journalArticle

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Abstract

Eighty-five subjects were tested for the presence of circulating candidal antigen (CAg) and anti-candidal antibody (CAb) using both an enzyme immunoassay (ELISA) and counterimmunoelectrophoresis (CIE). The 72 studied controls included laboratory volunteers; hospitalized patients without evidence of infection; febrile hospitalized patients without evidence of candidiasis; and patients with superficial candidiasis and candiduria. The control subjects were compared with 13 patients with proven disseminated candidal infection (disease prevalence = 15%). The ELISA CAb test was of greater individual sensitivity (92%) in separating patients with systemic candidiasis from all controls combined than the ELISA CAg, CIE CAg, or CIE CAb test (61%, 15%, 69%, respectively). The CIE CAg test, though specific (100%), was insensitive. Sensitivity, specificity, and predictive values were generally enhanced by employing combinations of tests. Sera from patients with disseminated candidiasis were much more likely to yield a positive result by two or more serologic tests than were control sera (p = less than 0.0004). The sensitivity of combinations ranged from 15% to 92%. The specificity of combinations ranged from 21% to 100%. The predictive value positive of combinations test ranged from 40% to 100%. Predictive value negative of combinations ranged from 69% to 98%. Patients with a variety of superficial and deep candidal infections apparently have detectable circulating CAb and/or CAg. The ELISA CAb test was superior to the other tests in identifying patients with disseminated candidiasis. Combinations of serologic tests may be superior to individual tests in the diagnosis or exclusion of serious disease due to Candida albicans.

Original languageEnglish (US)
Pages (from-to)135-142
Number of pages8
JournalAmerican Journal of the Medical Sciences
Volume290
Issue number4
StatePublished - Oct 1985

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Immunologic Techniques
Candidiasis
Counterimmunoelectrophoresis
Antigens
Enzyme-Linked Immunosorbent Assay
Antibodies
Serologic Tests
Infection
Serum
Candida albicans
Immunoenzyme Techniques
Volunteers
Anti-Idiotypic Antibodies
Fever
Sensitivity and Specificity

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Fisher, J. F., Trincher, R. C., Agel, J. F., Buxton, T. B., Walker, C. A., Johnson, D. H., ... Rissing, J. P. (1985). Disseminated candidiasis: a comparison of two immunologic techniques in the diagnosis. American Journal of the Medical Sciences, 290(4), 135-142.

Disseminated candidiasis : a comparison of two immunologic techniques in the diagnosis. / Fisher, J. F.; Trincher, R. C.; Agel, J. F.; Buxton, T. B.; Walker, C. A.; Johnson, D. H.; Cormier, R. E.; Chew, W. H.; Rissing, J. P.

In: American Journal of the Medical Sciences, Vol. 290, No. 4, 10.1985, p. 135-142.

Research output: Contribution to journalArticle

Fisher, JF, Trincher, RC, Agel, JF, Buxton, TB, Walker, CA, Johnson, DH, Cormier, RE, Chew, WH & Rissing, JP 1985, 'Disseminated candidiasis: a comparison of two immunologic techniques in the diagnosis.', American Journal of the Medical Sciences, vol. 290, no. 4, pp. 135-142.
Fisher, J. F. ; Trincher, R. C. ; Agel, J. F. ; Buxton, T. B. ; Walker, C. A. ; Johnson, D. H. ; Cormier, R. E. ; Chew, W. H. ; Rissing, J. P. / Disseminated candidiasis : a comparison of two immunologic techniques in the diagnosis. In: American Journal of the Medical Sciences. 1985 ; Vol. 290, No. 4. pp. 135-142.
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abstract = "Eighty-five subjects were tested for the presence of circulating candidal antigen (CAg) and anti-candidal antibody (CAb) using both an enzyme immunoassay (ELISA) and counterimmunoelectrophoresis (CIE). The 72 studied controls included laboratory volunteers; hospitalized patients without evidence of infection; febrile hospitalized patients without evidence of candidiasis; and patients with superficial candidiasis and candiduria. The control subjects were compared with 13 patients with proven disseminated candidal infection (disease prevalence = 15{\%}). The ELISA CAb test was of greater individual sensitivity (92{\%}) in separating patients with systemic candidiasis from all controls combined than the ELISA CAg, CIE CAg, or CIE CAb test (61{\%}, 15{\%}, 69{\%}, respectively). The CIE CAg test, though specific (100{\%}), was insensitive. Sensitivity, specificity, and predictive values were generally enhanced by employing combinations of tests. Sera from patients with disseminated candidiasis were much more likely to yield a positive result by two or more serologic tests than were control sera (p = less than 0.0004). The sensitivity of combinations ranged from 15{\%} to 92{\%}. The specificity of combinations ranged from 21{\%} to 100{\%}. The predictive value positive of combinations test ranged from 40{\%} to 100{\%}. Predictive value negative of combinations ranged from 69{\%} to 98{\%}. Patients with a variety of superficial and deep candidal infections apparently have detectable circulating CAb and/or CAg. The ELISA CAb test was superior to the other tests in identifying patients with disseminated candidiasis. Combinations of serologic tests may be superior to individual tests in the diagnosis or exclusion of serious disease due to Candida albicans.",
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