TY - JOUR
T1 - Performance of existing clinical scores and laboratory tests for the diagnosis of invasive candidiasis in critically ill, nonneutropenic, adult patients
T2 - A systematic review with qualitative evidence synthesis
AU - the FUNDICU investigators
AU - Giacobbe, Daniele Roberto
AU - Asperges, Erika
AU - Cortegiani, Andrea
AU - Grecchi, Cecilia
AU - Rebuffi, Chiara
AU - Zuccaro, Valentina
AU - Scudeller, Luigia
AU - Bassetti, Matteo
AU - Akova, Murat
AU - Alastruey-Izquierdo, Ana
AU - Arikan-Akdagli, Sevtap
AU - Azoulay, Elie
AU - Blot, Stijn I.
AU - Cornely, Oliver A.
AU - Lass-Flörl, Cornelia
AU - Koehler, Philipp
AU - Cuenca-Estrella, Manuel
AU - de Lange, Dylan W.
AU - De Rosa, Francesco G.
AU - De Waele, Jan J.
AU - Dimopoulos, George
AU - Garnacho-Montero, José
AU - Hoenigl, Martin
AU - Kanj, Souha S.
AU - Lamoth, Frederic
AU - Maertens, Johan
AU - Martin-Loeches, Ignacio
AU - Muñoz, Patricia
AU - Kullberg, Bart J.
AU - Agvald-Ohman, Christina
AU - Poulakou, Garyphallia
AU - Rello, Jordi
AU - Sanguinetti, Maurizio
AU - Taccone, Fabio S.
AU - Timsit, Jean François
AU - Torres, Antoni
AU - Vazquez, Jose A.
AU - Wauters, Joost
AU - Calandra, Thierry
AU - Tejada, Sofia
AU - Karaiskos, Ilias
AU - Peghin, Maddalena
AU - Vena, Antonio
AU - Mortensen, Klaus L.
AU - Lebihan, Clement
AU - Mercier, Toine
N1 - Publisher Copyright:
© 2022 Wiley-VCH GmbH.
PY - 2022/12
Y1 - 2022/12
N2 - 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.
AB - 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.
KW - Candida
KW - biomarker
KW - candidaemia
KW - deep-seated candidiasis
KW - diagnosis
KW - invasive candidiasis
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U2 - 10.1111/myc.13515
DO - 10.1111/myc.13515
M3 - Review article
C2 - 35938455
AN - SCOPUS:85137418108
SN - 0933-7407
VL - 65
SP - 1073
EP - 1111
JO - Mycoses
JF - Mycoses
IS - 12
ER -