Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Dec;65(12):1073-1111.
doi: 10.1111/myc.13515. Epub 2022 Sep 4.

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

Daniele Roberto Giacobbe  1   2 , Erika Asperges  3 , Andrea Cortegiani  4   5 , Cecilia Grecchi  3 , Chiara Rebuffi  6 , Valentina Zuccaro  3 , Luigia Scudeller  7 , Matteo Bassetti  1   2 ; FUNDICU investigators
Collaborators, Affiliations

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

Daniele Roberto Giacobbe et al. Mycoses. 2022 Dec.

Abstract

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: 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: 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: 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: 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.

Keywords: Candida; biomarker; candidaemia; deep-seated candidiasis; diagnosis; invasive candidiasis.

PubMed Disclaimer

References

REFERENCES

    1. Bassetti M, Giacobbe DR, Vena A, et al. Incidence and outcome of invasive candidiasis in intensive care units (ICUs) in Europe: results of the EUCANDICU project. Crit Care. 2019;23(1):219.
    1. Delaloye J, Calandra T. Invasive candidiasis as a cause of sepsis in the critically ill patient. Virulence. 2014;5(1):161-169.
    1. Ostrosky-Zeichner L, Al-Obaidi M. Invasive fungal infections in the intensive care unit. Infect Dis Clin North Am. 2017;31(3):475-487.
    1. Bassetti M, Righi E, Ansaldi F, et al. A multicenter study of septic shock due to candidemia: outcomes and predictors of mortality. Intensive Care Med. 2014;40(6):839-845.
    1. Bassetti M, Vena A, Meroi M, et al. Factors associated with the development of septic shock in patients with candidemia: a post hoc analysis from two prospective cohorts. Crit Care. 2020;24(1):117.

Publication types

Substances

Supplementary concepts

LinkOut - more resources