Evaluation Of A Latex Agglutination Test For The Identification Of Candida Species In Vaginal Discharge

Abstract

Background: The diagnosis of Candida vulvovaginitis using historical symptoms, pelvic examination findings, and results of traditional in-office laboratory tests is often inaccurate. Although Candida cultures can verify the diagnosis, they are not routinely used.

Methods: We prospectively compared the accuracy of a commercially available, in-office, rapid, latex agglutination test (CandidaSure ™) for the identification of Candida species with results from Candida culture.

Results: The sensitivity of the latex agglutination test was 66 percent and the specificity was 63 percent when compared with Candida culture results in patients with vaginal symptoms. When compared with a microscopic evaluation using potassium hydroxide (KOH), the CandidaSure ™ test had greater sensitivity but a lower specificity. In 74 percent of cases with a positive KOH preparation, yeast forms were present on culture, and little was gained by adding the CandidaSure ™ test in this situation. The addition of the CandidaSure ™ test in those cases with a negative KOH preparation resulted in increased sensitivity but also increased the number of false-positive diagnoses.

Conclusions: The CandidaSure ™ test has greater sensitivity than the KOH preparation, but it is less predictive of a positive culture. Because of this limitation, Candida should be documented by culture for any patient who has recurrent or persistent disease and a negative KOH slide.