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Evaluation of a new test for candidiasis diagnosis in elderly people

S. Montal, P. Bousquet, P. Rispail, P. Tramini - France

Objective: The purpose of this study was to evaluate a new test for candidiasis diagnosis (fungi-dent color^® test) in an institutionalised elderly population.
Background: Yeasts normally exist in the human body flora and exploit a situation of weakness in the host. Epidemiologic analyses of yeast infection in the oral cavity showed that the most frequently involved species were Candida albicans.
Materials and methods: This study included 73 persons in the short-term and long-term geriatric department of the Montpellier hospital. Oral examinations were performed and the presence of Candida was evaluated: the fungi-dent^® Color diagnostic method was compared both to the classical culture analysis method, considered as the gold standard, and to the visual clinical diagnostic.
Results: The fungi test yielded a sensitivity value of 64.6% (CI: 53.6% - 75.6%) and a specificity of 96.0% (CI: 92.0% - 100%), whereas the diagnostic method through clinical examination disclosed only 22.5% candidiasis. The area under the ROC curve was equal to 0.81. The mean pH value was significantly higher when candidiasis was present (6.15 vs 5.78, p = 0.007).
Conclusion: Statistical analyses showed that the Fungi-dent-color^® test was eligible to be validated for community use, with better characteristics than a routine clinical diagnosis and with a reasonably rapid and reliable diagnostic outcome.

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