Reed B D, Pierson C L
Department of Family Practice, University of Michigan Medical School, Ann Arbor 48109-0708.
J Am Board Fam Pract. 1992 Jul-Aug;5(4):375-80.
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.
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.
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.
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.
依据既往症状、盆腔检查结果以及传统门诊实验室检查结果来诊断念珠菌性外阴阴道炎，常常并不准确。虽然念珠菌培养能够证实诊断，但并未常规使用。
我们前瞻性地比较了一种市售的、门诊用的快速乳胶凝集试验（CandidaSure）用于鉴定念珠菌属的准确性与念珠菌培养结果。
在有阴道症状的患者中，与念珠菌培养结果相比，乳胶凝集试验的敏感性为66%，特异性为63%。与使用氢氧化钾（KOH）的显微镜检查相比，CandidaSure试验具有更高的敏感性，但特异性较低。在74%的KOH制剂检查结果为阳性的病例中，培养发现有酵母形态，在此情况下增加CandidaSure试验收获不大。在KOH制剂检查结果为阴性的病例中增加CandidaSure试验可提高敏感性，但也增加了假阳性诊断的数量。
CandidaSure试验比KOH制剂具有更高的敏感性，但对培养阳性的预测性较差。由于这一局限性，对于任何患有复发性或持续性疾病且KOH涂片检查结果为阴性的患者，都应通过培养来确定念珠菌感染。
