Efficient Diagnosis of Vulvovaginal Candidiasis by Use of a New Rapid Immunochromatography Test

• Published in: Journal of Clinical Microbiology 2009-12, Vol.47 (12), p.3821-3825
• Main Authors: Marot-Leblond, Agnes, Nail-Billaud, Sandrine, Pilon, Françoise, Beucher, Bertrand, Poulain, Daniel, Robert, Raymond
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Candida; Candida - immunology; Candida - isolation & purification; Candidiasis, Vulvovaginal - diagnosis; Candidiasis, Vulvovaginal - microbiology; Chromatography - methods; Culture Media; Female; Fundamental and applied biological sciences. Psychology; Humans; Immunoassay - methods; Immunoglobulin M - immunology; Life Sciences; Mannans - analysis; Mannans - immunology; Microbiology; Microscopy; Mycology; Predictive Value of Tests; Reagent Kits, Diagnostic; Sensitivity and Specificity; Time Factors; Vaginal Smears
• ISSN: 0095-1137; 1098-660X; 1098-660X
• DOI: 10.1128/JCM.01168-09

The clinical symptoms of vulvovaginal candidiasis (VVC) are nonspecific, and misdiagnosis is common, leading to a delay in the initiation of antifungal treatment. We evaluated a new immunochromatography test (ICT), the CandiVagi assay (SR2B, Avrille, France), for the rapid diagnosis of VVC. This test, which employs an immunoglobulin M antibody directed against the β-1,2-mannopyranosyl epitopes found in the yeast cell wall, was compared with direct microscopic examination and culture of vaginal swabs. Two-hundred five women were investigated, including 130 women with symptomatic vaginitis and 75 asymptomatic controls. Two vaginal swabs were obtained from each woman: one was used to prepare a wet mount and Gram-stained preparations for direct microscopic examination and was also cultured on Sabouraud dextrose agar for the isolation of Candida spp., and the second swab was used for ICT. The sensitivities of microscopic examination, culture, and ICT for the diagnosis of VVC were 61%, 100%, and 96.6%, respectively, while the specificities of the three methods were 100%, 82%, and 98.6%, respectively. ICT had a negative predictive value of 98.6%, a positive predictive value of 96.6%, and an efficiency of 98%. ICT provided a rapid result and a better compromise between sensitivity and specificity than conventional microscopy and culture for the diagnosis of VVC. This easy-to-perform diagnostic test will be useful to practitioners treating women with symptoms of vaginitis.