Evaluation of the Cica Fungi Test Candida, a Novel Serum Candida Mannan Antigen Kit, and Its Comparison with Cand-Tec in Candidemia Patients

Abstract

The Cica Fungi Test Candida is a novel immunoassay test that is used in Japan to detect Candida mannan antigens. A total of 130 samples from 89 cases in which the β-D-glucan assay (MK method) was positive were collected between July 2007 and August 2008 at Nagasaki University Hospital, and the Cica Fungi Test Candida and Cand-Tec were performed. Diagnosis of candidemia was based on a positive culture for Candida spp. from blood or other sterile clinical specimens. A total of 19 samples from 16 cases with candidemia, and 111 samples from 73 cases without microbiological evidence of candidemia, were obtained. The sensitivity and specificity of the Cica Fungi Test and Cand-Tec were 63.2 and 95.5%, and 52.6 and 50.5%, respectively. The Cica Fungi Test showed significantly higher specificity than Cand-Tec (P<0.01). The β-D-glucan assay values were significantly higher in the candidemia samples than in the non-candidemia samples (P=0.0003), a result that was well correlated with the Cica Fungi Test (P=0.0005). The Cica Fungi Test was thus found to be more reliable and specific than Cand-Tec, and the combined evaluation with the β-D-glucan assay was more efficient for diagnosis of candidemia.