CANDIDA ANTIGEN TITER DILUTION AND DEATH AFTER INJURY

Background Candida infections affect outcome after injury. Candida ant igen titres were used to detect these infections early. This study was undertaken to correlate Candida antigen titre dilution with conventio nal injury scoring and outcome after severe injury. Methods Candida an tigen 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)) de veloped raised Candida antigen titres. Multivariate analysis showed th at age and Candida antigen titre correlated significantly with mortali ty, but not with each other. Culture evidence of Candida, or lack ther eof, did not correlate with Candida antigen titre or mortality. Sixtee n of 75 patients died, 14 from bacterial sepsis and none from Candida infection. Conclusion In seriously injured adults, the mortality rate is related to raised Candida antigen titres. The association between C andida antigen titre and mortality, although real, remains unexplained .