title: Candida antigen titre dilution and death after injury.
abstract: BACKGROUND
  Candida infections affect outcome after injury. Candida antigen titres were used to detect these infections early. This study was undertaken to correlate Candida antigen titre dilution with conventional injury scoring and outcome after severe injury.
  
  
  METHODS
  Candida antigen titres were determined by agglutination when clinically apparent source(s) of Candida were noted, when Candida was grown in culture of body fluids, or when unexplained clinical deterioration occurred. The findings were compared with the Injury Severity Score (ISS).
  
  
  RESULTS
  Seventy-five seriously injured adults (median ISS 25 (range 18-50)) developed raised Candida antigen titres. Multivariate analysis showed that age and Candida antigen titre correlated significantly with mortality, but not with each other. Culture evidence of Candida, or lack thereof, did not correlate with Candida antigen titre or mortality. Sixteen of 75 patients died, 14 from bacterial sepsis and none from Candida infection.
  
  
  CONCLUSIONS
  In seriously injured adults, the mortality rate is related to raised Candida antigen titres. The association between Candida antigen titre and mortality, although real, remains unexplained.
authors.affiliation: Department of Surgery, University of South Florida, Tampa, USA.
authors.forename: A S
authors.initials: AS
authors.lastname: Rosemurgy
authors.forename: E E
authors.initials: EE
authors.lastname: Zervos
authors.forename: J F
authors.initials: JF
authors.lastname: Sweeney
authors.forename: J Y
authors.initials: JY
authors.lastname: Djeu
mesh_terms: D000328:Adult; D000946:Antigens, Fungal / Q000032:analysis* / Q000276:immunology; D015415:Biomarkers / Q000032:analysis; D002175:Candida / Q000276:immunology; D002177:Candidiasis / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology*; D005260:Female; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D012680:Sensitivity and Specificity; D016019:Survival Analysis; D015996:Survival Rate; D014949:Wounds, Nonpenetrating / Q000276:immunology* / Q000382:microbiology; D014950:Wounds, Penetrating / Q000276:immunology* / Q000382:microbiology
chemical_list: D000946:Antigens, Fungal; D015415:Biomarkers