000061619 001__ 61619
000061619 005__ 20200221144307.0
000061619 0247_ $$2doi$$a10.1186/s13054-016-1324-3
000061619 0248_ $$2sideral$$a98997
000061619 037__ $$aART-2016-98997
000061619 041__ $$aeng
000061619 100__ $$aLeón, C.
000061619 245__ $$aContribution of Candida biomarkers and DNA detection for the diagnosis of invasive candidiasis in ICU patients with severe abdominal conditions
000061619 260__ $$c2016
000061619 5060_ $$aAccess copy available to the general public$$fUnrestricted
000061619 5203_ $$aBackground: To assess the performance of Candida albicans germ tube antibody (CAGTA), (1???3)-ß-D-glucan (BDG), mannan antigen (mannan-Ag), anti-mannan antibodies (mannan-Ab), and Candida DNA for diagnosing invasive candidiasis (IC) in ICU patients with severe abdominal conditions (SAC).
Methods: A prospective study of 233 non-neutropenic patients with SAC on ICU admission and expected stay?=?7 days. CAGTA (cutoff positivity?=?1/160), BDG (=80, 100 and 200 pg/mL), mannan-Ag (=60 pg/mL), mannan-Ab (=10 UA/mL) were measured twice a week, and Candida DNA only in patients treated with systemic antifungals. IC diagnosis required positivities of two biomarkers in a single sample or positivities of any biomarker in two consecutive samples. Patients were classified as neither colonized nor infected (n?=?48), Candida spp. colonization (n?=?154) (low-grade, n?=?130; high-grade, n?=?24), and IC (n?=?31) (intra-abdominal candidiasis, n?=?20; candidemia, n?=?11).
Results: The combination of CAGTA and BDG positivities in a single sample or at least one of the two biomarkers positive in two consecutive samples showed 90.3 % (95 % CI 74.2–98.0) sensitivity, 42.1 % (95 % CI 35.2–98.8) specificity, and 96.6 % (95 % CI 90.5–98.8) negative predictive value. BDG positivities in two consecutive samples had 76.7 % (95 % CI 57.7–90.1) sensitivity and 57.2 % (95 % CI 49.9–64.3) specificity. Mannan-Ag, mannan-Ab, and Candida DNA individually or combined showed a low discriminating capacity.
Conclusions: Positive Candida albicans germ tube antibody and (1???3)-ß-D-glucan in a single blood sample or (1???3)-ß-D-glucan positivity in two consecutive blood samples allowed discriminating invasive candidiasis from Candida spp. colonization in critically ill patients with severe abdominal conditions. These findings may be helpful to tailor empirical antifungal therapy in this patient population.
000061619 536__ $$9info:eu-repo/grantAgreement/ES/FEDER/PI13-01168
000061619 540__ $$9info:eu-repo/semantics/openAccess$$aby$$uhttp://creativecommons.org/licenses/by/3.0/es/
000061619 590__ $$a5.358$$b2016
000061619 591__ $$aCRITICAL CARE MEDICINE$$b6 / 33 = 0.182$$c2016$$dQ1$$eT1
000061619 592__ $$a2.373$$b2016
000061619 593__ $$aCritical Care and Intensive Care Medicine$$c2016$$dQ1
000061619 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000061619 700__ $$aRuiz-Santana, S.
000061619 700__ $$aSaavedra, P.
000061619 700__ $$aCastro, C.
000061619 700__ $$aLoza, A.
000061619 700__ $$aZakariya, I.
000061619 700__ $$aÚbeda, A.
000061619 700__ $$aParra, M.
000061619 700__ $$aMacías, D.
000061619 700__ $$aTomás, J.I.
000061619 700__ $$0(orcid)0000-0001-7294-245X$$aRezusta, A.$$uUniversidad de Zaragoza
000061619 700__ $$aRodríguez, A.
000061619 700__ $$aGómez, F.
000061619 700__ $$aMartín-Mazuelos, E.
000061619 7102_ $$11008$$2630$$aUniversidad de Zaragoza$$bDpto. Microb.Med.Pr.,Sal.Públ.$$cÁrea Microbiología
000061619 773__ $$g20, 149 (2016), [14 pp]$$pCrit. care$$tCritical care$$x1364-8535
000061619 8564_ $$s962279$$uhttp://zaguan.unizar.es/record/61619/files/texto_completo.pdf$$yVersión publicada
000061619 8564_ $$s86969$$uhttp://zaguan.unizar.es/record/61619/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000061619 909CO $$ooai:zaguan.unizar.es:61619$$particulos$$pdriver
000061619 951__ $$a2020-02-21-13:35:33
000061619 980__ $$aARTICLE