Incidence and significance of candida antigen in low-risk and high-risk patient populations.

A latex agglutination test which detects candida antigen in patients with disseminated infection was used to screen 328 patients. Of these patients 100 had renal failure but no signs or symptoms of candida infection, and 100 had high rheumatoid factor titers but also no signs or symptoms of candida infection. The remaining 128 patients were considered at high risk of developing systemic candida infection. Sequential titers were also determined in a number of these patients. The incidence of candida antigen titers greater than or equal to 1:4 in the low-risk population was 3% as compared to 53% in the high-risk group. None of the patients with positive rheumatoid factor titers had candida antigen titers greater than or equal to 1:2, however 13% had nonspecific agglutination at titers greater than 1:2. The incidence of nonspecific agglutination increased with increasing rheumatoid factor titers. In general the candida antigen titers correlated well with clinical findings and with the course of infection in those patients in whom sequential candida antigen titers were determined. This latex test thus appears to be a useful adjunct procedure for the diagnosis of serious candida infections.