Performance of existing clinical scores and laboratory tests for the diagnosis of invasive candidiasis in critically ill, nonneutropenic, adult patients: A systematic review with qualitative evidence synthesis.
Candida
biomarker
candidaemia
deep-seated candidiasis
diagnosis
invasive candidiasis
Journal
Mycoses
ISSN: 1439-0507
Titre abrégé: Mycoses
Pays: Germany
ID NLM: 8805008
Informations de publication
Date de publication:
Dec 2022
Dec 2022
Historique:
received:
08
02
2022
accepted:
03
08
2022
pubmed:
9
8
2022
medline:
8
11
2022
entrez:
8
8
2022
Statut:
ppublish
Résumé
The Fungal Infections Definitions in Intensive Care Unit (ICU) patients (FUNDICU) project aims to provide standard sets of definitions for invasive fungal diseases in critically ill, adult patients. To summarise the available evidence on the diagnostic performance of clinical scores and laboratory tests for invasive candidiasis (IC) in nonneutropenic, adult critically ill patients. A systematic review was performed to evaluate studies assessing the diagnostic performance for IC of clinical scores and/or laboratory tests vs. a reference standard or a reference definition in critically ill, nonneutropenic, adult patients in ICU. Clinical scores, despite the heterogeneity of study populations and IC prevalences, constantly showed a high negative predictive value (NPV) and a low positive predictive value (PPV) for the diagnosis of IC in the target population. Fungal antigen-based biomarkers (with most studies assessing serum beta-D-glucan) retained a high NPV similar to that of clinical scores, with a higher PPV, although the latter showed important heterogeneity across studies, possibly reflecting the targeted or untargeted use of these tests in patients with a consistent clinical picture and risk factors for IC. Both clinical scores and laboratory tests showed high NPV for the diagnosis of IC in nonneutropenic critically ill patients. The PPV of laboratory tests varies significantly according to the baseline patients' risk of IC. This qualitative synthesis will provide the FUNDICU panel with baseline evidence to be considered during the development of definitions of IC in critically ill, nonneutropenic adult patients in ICU.
Sections du résumé
BACKGROUND
BACKGROUND
The Fungal Infections Definitions in Intensive Care Unit (ICU) patients (FUNDICU) project aims to provide standard sets of definitions for invasive fungal diseases in critically ill, adult patients.
OBJECTIVES
OBJECTIVE
To summarise the available evidence on the diagnostic performance of clinical scores and laboratory tests for invasive candidiasis (IC) in nonneutropenic, adult critically ill patients.
METHODS
METHODS
A systematic review was performed to evaluate studies assessing the diagnostic performance for IC of clinical scores and/or laboratory tests vs. a reference standard or a reference definition in critically ill, nonneutropenic, adult patients in ICU.
RESULTS
RESULTS
Clinical scores, despite the heterogeneity of study populations and IC prevalences, constantly showed a high negative predictive value (NPV) and a low positive predictive value (PPV) for the diagnosis of IC in the target population. Fungal antigen-based biomarkers (with most studies assessing serum beta-D-glucan) retained a high NPV similar to that of clinical scores, with a higher PPV, although the latter showed important heterogeneity across studies, possibly reflecting the targeted or untargeted use of these tests in patients with a consistent clinical picture and risk factors for IC.
CONCLUSIONS
CONCLUSIONS
Both clinical scores and laboratory tests showed high NPV for the diagnosis of IC in nonneutropenic critically ill patients. The PPV of laboratory tests varies significantly according to the baseline patients' risk of IC. This qualitative synthesis will provide the FUNDICU panel with baseline evidence to be considered during the development of definitions of IC in critically ill, nonneutropenic adult patients in ICU.
Substances chimiques
Antifungal Agents
0
Types de publication
Systematic Review
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
1073-1111Subventions
Organisme : The present project did not require additional funding from routine research activities. Costs for open access publications will be covered by research funds of the main authors
Investigateurs
Murat Akova
(M)
Ana Alastruey-Izquierdo
(A)
Sevtap Arikan-Akdagli
(S)
Elie Azoulay
(E)
Stijn I Blot
(SI)
Oliver A Cornely
(OA)
Cornelia Lass-Flörl
(C)
Philipp Koehler
(P)
Manuel Cuenca-Estrella
(M)
Dylan W de Lange
(DW)
Francesco G De Rosa
(FG)
Jan J De Waele
(JJ)
George Dimopoulos
(G)
José Garnacho-Montero
(J)
Martin Hoenigl
(M)
Souha S Kanj
(SS)
Frederic Lamoth
(F)
Johan Maertens
(J)
Ignacio Martin-Loeches
(I)
Patricia Muñoz
(P)
Bart J Kullberg
(BJ)
Christina Agvald-Ohman
(C)
Garyphallia Poulakou
(G)
Jordi Rello
(J)
Maurizio Sanguinetti
(M)
Fabio S Taccone
(FS)
Jean-François Timsit
(JF)
Antoni Torres
(A)
Jose A Vazquez
(JA)
Joost Wauters
(J)
Thierry Calandra
(T)
Sofia Tejada
(S)
Ilias Karaiskos
(I)
Maddalena Peghin
(M)
Antonio Vena
(A)
Klaus L Mortensen
(KL)
Clement Lebihan
(C)
Toine Mercier
(T)
Informations de copyright
© 2022 Wiley-VCH GmbH.
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