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. 2021 Feb 28;7(3):176.
doi: 10.3390/jof7030176.

Performance of Existing Definitions and Tests for the Diagnosis of Invasive Fungal Diseases other than Invasive Candidiasis and Invasive Aspergillosis in Critically Ill, Adult Patients: A Systematic Review with Qualitative Evidence Synthesis

Daniele R Giacobbe  1   2 , Andrea Cortegiani  3   4 , Ilias Karaiskos  5 , Toine Mercier  6   7 , Sofia Tejada  8   9 , Maddalena Peghin  10 , Cecilia Grecchi  11   12 , Chiara Rebuffi  13 , Erika Asperges  11 , Valentina Zuccaro  11 , Luigia Scudeller  14 , Matteo Bassetti  1   2 ; The Fundicu Investigators
Collaborators, Affiliations

Performance of Existing Definitions and Tests for the Diagnosis of Invasive Fungal Diseases other than Invasive Candidiasis and Invasive Aspergillosis in Critically Ill, Adult Patients: A Systematic Review with Qualitative Evidence Synthesis

Daniele R Giacobbe et al. J Fungi (Basel). .

Abstract

The Fungal Infections Definitions in Intensive Care Unit (ICU) patients (FUNDICU) project aims to provide standard sets of definitions for invasive fungal diseases (IFDs) in critically ill, adult patients, including invasive aspergillosis (IA), invasive candidiasis (IC), Pneumocystis jirovecii pneumonia (PJP), and other non-IA, non-IC IFDs. The first step of the project was the conduction of separated systematic reviews of the characteristics and applicability to critically ill, adult patients outside classical populations at risk (hematology patients, solid organ transplant recipients) of available definitions and diagnostic tests for IFDs. We report here the results of two systematic reviews exploring the performance of available definitions and tests, for PJP and for other non-IA, non-IC IFDs. Starting from 2585 and 4584 records for PJP and other IFDs, respectively, 89 and 61 studies were deemed as eligible for full-text evaluation. However, only two studies for PJP and no studies for other IFDs met the FUNDICU protocol criteria for inclusion in qualitative synthesis. Currently, there is no sufficient solid data for directly evaluating the performance of existing definitions and laboratory tests for the diagnosis of PJP and other non-IA, non-IC IFDs in critically ill adult patients outside classical populations at risk.

Keywords: IFD; PJP; biomarker; diagnosis; invasive fungal diseases; pneumocystis.

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Conflict of interest statement

Outside the submitted work, M.B. has received funding for scientific advisory boards, travel, and speaker honoraria from Angelini, Astellas, AstraZeneca, Basilea, Bayer, BioMérieux, Cidara, Correvio, Cubist, Menarini, Molteni, MSD, Nabriva, Paratek, Pfizer, Roche, Shionogi, Tetraphase, Thermo Fisher, and The Medicine Company. D.R.G. reports personal fees from Stepstone Pharma GmbH and unconditional grants from MSD Italia and Correvio Italia. The other authors report no conflicts of interest.

Figures

Figure 1
Figure 1
Flow diagram of the study selection process for Pneumocystis jirovecii pneumonia (PJP).
Figure 2
Figure 2
Risk of bias in included studies for Pneumocystis jirovecii pneumonia. Risk of bias: present = black; absent = white; not applicable = gray.
Figure 3
Figure 3
Flow diagram of the study selection process for other invasive fungal diseases.
See this image and copyright information in PMC

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