Abstract:

Objective To compare the detection efficacy of direct microscopic examination and antigen detection in oral candidiasis infection, and provide a basis for clinical selection of rapid detection methods. Methods Oral swabs were collected from patients with suspected oral candidiasis in the Department of Oral Mucosal Diseases at Affiliated Stomatological Hospital of Nanjing Medical University between December 2024 and February 2025. Each specimen was detected by direct microscopic examination, antigen detection and cultivation method. Using the cultivation method as the gold standard, the positive rates of the other two methods were assessed, and the consistency with the cultivation method, and various evaluation indices such as sensitivity, specificity, false negative rate, false positive rate, negative predictive value and positive predictive value were compared. Results The antigen detection method demonstrated a significantly higher positive rate than the direct microscopic examination (P<0.01). Both methods showed consistency with the results of the cultivation method (P<0.05), and the antigen detection method (Kappa=0.417) had a higher degree of consistency. The sensitivity, negative predictive value and positive predictive value of the Candida albicans antigen detection were significantly higher than those of the direct microscopic examination (P<0.05) and the false negative rate was significantly lower than that of the direct microscopic examination (P<0.01). The difference in specificity and false positive rate between the two methods was not significant (P>0.05). Conclusion The antigen detection method has higher positive rate, sensitivity, negative predictive value, positive predictive value and lower false negative rate. It also has a higher degree of consistency with cultivation method. Therefore it is more suitable for rapid clinical diagnosis.

Key words: Candida albicans, direct microscopic examination, antigen detection, cultivation