Evaluation of a new test for candidiasis diagnosis in elderly people

The purpose of this study was to evaluate a new test for candidiasis diagnosis (fungi-dent color test) in an institutionalised elderly population.

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.

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.

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).

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.