Articles producció científica> Medicina i Cirurgia

Contribution of Candida biomarkers and DNA detection for the diagnosis of invasive candidiasis in ICU patients with severe abdominal conditions

  • Identification data

    Identifier: imarina:2634122
    Authors:
    León C, Ruiz-Santana S, Saavedra P, Castro C, Loza A, Zakariya I, Úbeda A, Parra M, Macías D, Tomás JI, Rezusta A, Rodríguez A, Gómez F, Martín-Mazuelos E, Cava Trem Study Group
    Abstract:
    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).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).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.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 empirica
  • Others:

    Author, as appears in the article.: León C, Ruiz-Santana S, Saavedra P, Castro C, Loza A, Zakariya I, Úbeda A, Parra M, Macías D, Tomás JI, Rezusta A, Rodríguez A, Gómez F, Martín-Mazuelos E, Cava Trem Study Group
    Department: Ciències Mèdiques Bàsiques Medicina i Cirurgia
    URV's Author/s: Gomez Bertomeu, Frederic-Francesc / Rodríguez Oviedo, Alejandro Hugo
    Keywords: Mannan antigen Invasive candidiasis Intra-abdominal candidiasis Candidemia Candida spp. colonization Candida pcr Candida albicans germ tube antibody Anti-mannan antibody (1 → 3)-β-d-glucan (1 ? 3)-?-d-glucan invasive candidiasis intra-abdominal candidiasis candidemia candida spp. colonization candida pcr candida albicans germ tube antibody anti-mannan antibody (1???3)-ß-d-glucan
    Abstract: 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).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).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.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.
    Thematic Areas: Saúde coletiva Nutrição Medicina veterinaria Medicina iii Medicina ii Medicina i Interdisciplinar Farmacia Engenharias iv Enfermagem Educação física Critical care medicine Critical care and intensive care medicine Ciências biológicas iii Ciências biológicas ii Ciências biológicas i Ciência de alimentos Biotecnología
    licence for use: https://creativecommons.org/licenses/by/3.0/es/
    ISSN: 1466609X
    Author's mail: alejandrohugo.rodriguez@urv.cat frederic-francesc.gomez@urv.cat
    Author identifier: 0000-0001-8828-5984 0000-0002-8039-2889
    Record's date: 2024-09-07
    Papper version: info:eu-repo/semantics/publishedVersion
    Link to the original source: https://ccforum.biomedcentral.com/articles/10.1186/s13054-016-1324-3
    Licence document URL: https://repositori.urv.cat/ca/proteccio-de-dades/
    Papper original source: Critical Care. 20 (1): 149-NA
    APA: León C, Ruiz-Santana S, Saavedra P, Castro C, Loza A, Zakariya I, Úbeda A, Parra M, Macías D, Tomás JI, Rezusta A, Rodríguez A, Gómez F, Martín-Mazuel (2016). Contribution of Candida biomarkers and DNA detection for the diagnosis of invasive candidiasis in ICU patients with severe abdominal conditions. Critical Care, 20(1), 149-NA. DOI: 10.1186/S13054-016-1324-3
    Article's DOI: 10.1186/S13054-016-1324-3
    Entity: Universitat Rovira i Virgili
    Journal publication year: 2016
    Publication Type: Journal Publications
  • Keywords:

    Critical Care and Intensive Care Medicine,Critical Care Medicine
    Mannan antigen
    Invasive candidiasis
    Intra-abdominal candidiasis
    Candidemia
    Candida spp. colonization
    Candida pcr
    Candida albicans germ tube antibody
    Anti-mannan antibody
    (1 → 3)-β-d-glucan
    (1 ? 3)-?-d-glucan
    invasive candidiasis
    intra-abdominal candidiasis
    candidemia
    candida spp. colonization
    candida pcr
    candida albicans germ tube antibody
    anti-mannan antibody
    (1???3)-ß-d-glucan
    Saúde coletiva
    Nutrição
    Medicina veterinaria
    Medicina iii
    Medicina ii
    Medicina i
    Interdisciplinar
    Farmacia
    Engenharias iv
    Enfermagem
    Educação física
    Critical care medicine
    Critical care and intensive care medicine
    Ciências biológicas iii
    Ciências biológicas ii
    Ciências biológicas i
    Ciência de alimentos
    Biotecnología
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