Pediatric case series evaluating a standardized Candida albicans skin test product. 2004

Linda K Ohri, and Jeanette M Manley, and Archana Chatterjee, and Nancy E Cornish
Department of Pharmacy Practice, School of Pharmacy and Allied Health Professions, Creighton University, 2500 California Plaza, Omaha, NE 68178-0117, USA. lohri@creighton.edu

BACKGROUND A ready-to-use, standardized Candida albicans skin test product (Candin) first became available in 1995. As of April 6, 2004, no published reports have been found describing efficacy or safety with pediatric use of this reagent. OBJECTIVE To present a case series describing experience with use of Candin to assess 78 pediatric cases for delayed-type hypersensitivity. METHODS The standardized C. albicans reagent was one of up to 4 antigens used to evaluate patients' cellular immunity. Candin was used with purified protein derivative tuberculosis testing for 76 patients (4 mo-16 y of age) and for anergy testing alone in 2 cases. Candin was used with at least one other skin test reagent for 24 subjects. RESULTS Fifty-three of 78 subjects (68%) responded to at least one skin test antigen. Candin had an overall response rate of 64% (50/78). There was a response to Candin in 54% (13/24) of subjects with multiple reagents applied, the highest rate of any antigen used. There was a 27% (3/11) positive Candin response for subjects <1 year of age; this compared with 21% and 23% in 2 published reports on use of nonstandardized tests for this age group. No adverse events were associated with use of Candin. CONCLUSIONS Candin testing gives similar or better response rates compared with published data on older, nonstandardized C. albicans reagents and other anergy test antigens used in this case series. It should be used in combination with multiple other control antigens to most effectively assess for anergy, particularly in infants, as well as in patients recognized to be immune deficient.

UI MeSH Term Description Entries
D006968 Hypersensitivity, Delayed An increased reactivity to specific antigens mediated not by antibodies but by sensitized T CELLS. Hypersensitivity, Tuberculin-Type,Hypersensitivity, Type IV,Tuberculin-Type Hypersensitivity,Type IV Hypersensitivity,Delayed Hypersensitivity,Delayed Hypersensitivities,Hypersensitivity, Tuberculin Type,Tuberculin Type Hypersensitivity,Tuberculin-Type Hypersensitivities,Type IV Hypersensitivities
D007111 Immunity, Cellular Manifestations of the immune response which are mediated by antigen-sensitized T-lymphocytes via lymphokines or direct cytotoxicity. This takes place in the absence of circulating antibody or where antibody plays a subordinate role. Cell-Mediated Immunity,Cellular Immune Response,Cell Mediated Immunity,Cell-Mediated Immunities,Cellular Immune Responses,Cellular Immunities,Cellular Immunity,Immune Response, Cellular,Immune Responses, Cellular,Immunities, Cell-Mediated,Immunities, Cellular,Immunity, Cell-Mediated,Response, Cellular Immune
D007223 Infant A child between 1 and 23 months of age. Infants
D008297 Male Males
D012015 Reference Standards A basis of value established for the measure of quantity, weight, extent or quality, e.g. weight standards, standard solutions, methods, techniques, and procedures used in diagnosis and therapy. Standard Preparations,Standards, Reference,Preparations, Standard,Standardization,Standards,Preparation, Standard,Reference Standard,Standard Preparation,Standard, Reference
D002176 Candida albicans A unicellular budding fungus which is the principal pathogenic species causing CANDIDIASIS (moniliasis). Candida albicans var. stellatoidea,Candida stellatoidea,Dematium albicans,Monilia albicans,Myceloblastanon albicans,Mycotorula albicans,Parasaccharomyces albicans,Procandida albicans,Procandida stellatoidea,Saccharomyces albicans,Syringospora albicans
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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