Clinical significance of the antibody-coated bacteria test in patients with candiduria.

The clinical significance of the antibody-coated bacteria (ACB) test was evaluated with urine from 20 patients with candiduria. The relationship between the in vitro antibody-coating test for Candida albicans, urinary immunoglobulin (Ig) levels and serum antibody titres was evaluated in 40 patients without candiduria, 23 of whom had bacterial urinary tract infection (UTI). Urine specimens from 19 of the 20 patients with candiduria gave a positive result regardless of clinical symptoms; 12/23 specimens of urine from patients with bacterial UTI were positive for antibody-coated C. albicans cells, but there were no positive samples in the patients without UTI. All of the coating-positive patients had serum antibody titres greater than or equal to 1:160, the class of antibody being dependent on the urinary Ig levels. The ACB test for candiduria is of little clinical value in indicating invasive Candida UTI as the Candida cells appear to adhere to antibodies in urine contaminated with circulating fluids.