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Intensive Care Medicine
Published in: Intensive Care Medicine 12/2009

01-12-2009 | Brief Report

Assessment of clinical risk predictive rules for invasive candidiasis in a prospective multicentre cohort of ICU patients

Authors: Elliott Geoffrey Playford, Jeff Lipman, Masrura Kabir, Emma S. McBryde, Graeme R. Nimmo, Anna Lau, Tania C. Sorrell

Published in: Intensive Care Medicine | Issue 12/2009

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Abstract

Purpose

To assess the generalisability of published clinical risk predictive models for invasive candidiasis in ICU patients.

Methods

The performance characteristics of published clinical risk factor-only and Candida colonisation-only predictive models for invasive candidiasis were assessed in a multicentre cohort of Australian ICU patients. Clinical risk factors and Candida colonisation parameters were collected prospectively from patients.

Results

The two clinical risk factor-only predictive models applied to an Australian patient cohort (n = 615) performed less well than in published studies involving derivation populations. Model performance characteristics improved when Candida colonisation parameters were added post-hoc.

Conclusions

Risk predictive models should factor in both clinical risk factors and Candida colonisation parameters. Integrating these models into therapeutic algorithms first requires external validation in different patient populations and settings.
Literature
1.
Kumar A, Roberts D, Wood K, Light B, Parrillo JE, Sharma S, Suppes R, Feinstein D, Zanotti S, Taiberg L, Gurka D, Kumar A, Cheang M (2006) Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock. Crit Care Med 34:1589–1596CrossRefPubMed
2.
Garey KW, Rege M, Pai MP, Mingo DE, Suda KJ, Turpin RS, Bearden DT (2006) Time to initiation of fluconazole therapy impacts mortality in patients with candidemia: a multi-institutional study. Clin Infect Dis 43:25–31CrossRefPubMed
3.
Morrell M, Fraser VJ, Kollef MH (2005) Delaying the empiric treatment of Candida bloodstream infection until positive blood culture results are obtained: a potential risk factor for hospital mortality. Antimicrob Agents Chemother 49:3640–3645CrossRefPubMed
4.
Reimer LG, Wilson ML, Weinstein MP (1997) Update on detection of bacteremia and fungemia. Clin Microbiol Rev 10:444–465PubMed
5.
Playford EG, Eggimann P, Calandra T (2008) Antifungals in the ICU. Curr Opin Infect Dis 21:610–619CrossRefPubMed
6.
Playford EG, Webster AC, Sorrell TC, Craig JC (2006) Antifungal agents for preventing fungal infections in non-neutropenic critically ill and surgical patients: systematic review and meta-analysis of randomized clinical trials. J Antimicrob Chemother 57:628–638CrossRefPubMed
7.
Ostrosky-Zeichner L, Sable C, Sobel J, Alexander BD, Donowitz G, Kan V, Kauffman CA, Kett D, Larsen RA, Morrison V, Nucci M, Pappas PG, Bradley ME, Major S, Zimmer L, Wallace D, Dismukes WE, Rex JH (2007) Multicenter retrospective development and validation of a clinical prediction rule for nosocomial invasive candidiasis in the intensive care setting. Eur J Clin Microbiol Infect Dis 26:271–276CrossRefPubMed
8.
Ostrosky-Zeichner L, Pappas P, Shoham S, Reboli A, Barron M, Sims C, Wood C, Sobel J (2006) Revalidation and improvement of a clinical prediction rule (CPR) for clinical trials on prophylaxis of invasive candidiasis (IC). In: Proceedings and abstract of the 46th interscience conference on antimicrobial agents and chemotherapy. American Society for Microbiology, San Francisco
9.
Pittet D, Monod M, Suter PM, Frenk E, Auckenthaler R (1994) Candida colonization and subsequent infections in critically ill surgical patients. Ann Surg 220:751–758CrossRefPubMed
10.
Paphitou NI, Ostrosky-Zeichner L, Rex J (2005) Rules for identifying patients at increased risk for candidal infections in the surgical intensive care unit: approach to developing practical criteria for systemic use in antifungal prophylaxis trials. Med Mycol 43:235–243CrossRefPubMed
11.
Eggimann P, Garbino J, Pittet D (2003) Epidemiology of Candida species infections in critically ill non-immunosuppressed patients. Lancet Infect Dis 3:685–702CrossRefPubMed
12.
Leon C, Ruiz-Santana S, Saavedra P, Galvan B, Blanco A, Castro C, Balasini C, Utande-Vazquez A, Gonzalez de Molina FJ, Blasco-Navalproto MA, Lopez MJ, Charles PE, Martin E, Hernandez-Viera MA, Cava Study Group (2009) Usefulness of the “Candida score” for discriminating between Candida colonization and invasive candidiasis in non-neutropenic critically ill patients: a prospective multicenter study. Crit Care Med 37:1624–1633CrossRefPubMed
13.
Leon C, Ruiz-Santana S, Saavedra S, Almirante B, Nolla-Salas J, Alvarez-Lerma F, Garnacho-Montero J, Leon MA (2006) A bedside scoring system (“Candida score”) for early antifungal treatment in nonneutropenic critically ill patients with Candida colonization. Crit Care Med 34:730–737CrossRefPubMed
14.
Lipsett PA (2006) Surgical critical care: fungal infections in surgical patients. Crit Care Med 34:S215–S224. PMID 16917426CrossRefPubMed
15.
Leon C, Ruiz-Santana S, Saavedra P, Galvan B, Blanco A, Castro C, Balasini C, Utande-Vazquez A, Gonzalez de Molina F, Blasco-Navalproto M, Lopez M, Charles PE, Martin E, Hernandez-Viera MA, Cava Study Group (2009) Usefulness of the “Candida score” for discriminating between Candida colonization and invasive candidiasis in non-neutropenic critically ill patients: a prospective multicenter study. Crit Care Med 37(5):1624–1633
16.
Levy MM, Fink MP, Marshall JC, Abraham E, Angus D, Cook DJ, Cohen J, Opal SM, Vincent JL, Ramsay G (2003) 2001 SCCM/ESICM/ACCP/ATS/SIS international sepsis definitions conference. Crit Care Med 31:1250–1256CrossRefPubMed
17.
Magill SS, Swoboda SM, Johnson EA, Merz WG, Pelz RK, Lipsett PA, Hendrix CW (2006) The association between anatomic site of Candida colonization, invasive candidiasis, and mortality in critically ill surgical patients. Diagn Microbiol Infect Dis 55:293–301CrossRefPubMed
Metadata
Title
Assessment of clinical risk predictive rules for invasive candidiasis in a prospective multicentre cohort of ICU patients
Authors
Elliott Geoffrey Playford
Jeff Lipman
Masrura Kabir
Emma S. McBryde
Graeme R. Nimmo
Anna Lau
Tania C. Sorrell
Publication date
01-12-2009
Publisher
Springer-Verlag
Published in
Intensive Care Medicine / Issue 12/2009
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-009-1619-9

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