Candida antigen latex test for detection of invasive candidiasis in immunocompromised patients.

Candida antigen latex agglutination testing was performed twice weekly during 217 admissions of 200 patients undergoing intensive chemotherapy alone or supported by autologous or allogeneic bone marrow transplantation. Eleven patients developed invasive candidiasis, three of whom survived; 6 (54.5%) of the 11 had positive Candida antigens. In 206 admissions, invasive candidiasis could not be documented. Of the 60 patients who died, 41 underwent autopsy examination, and 29 (71%) had positive Candida antigens. The latex test was also positive in 30 (20.5%) of the survivors and 10 (53%) of the unautopsied patients. Serum creatinine levels were greater than 2 mg/dL in 61% and 13% of patients with positive and negative Candida antigens, respectively (P less than .0001). For patients in whom the presence or absence of invasive candidiasis could be unequivocally demonstrated, the sensitivity, specificity, and positive and negative predictive values of the latex test at a titer of 1:4 were 54.5%, 29%, 17%, and 70.5%, respectively, suggesting that the latex test should not be used to diagnose invasive candidiasis in immunocompromised patients.