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1. Performance of Existing Definitions and Tests for the Diagnosis of Invasive Fungal Diseases other than Invasive Candidiasis and Invasive Aspergillosis in Critically Ill, Adult Patients: A Systematic Review with Qualitative Evidence Synthesis

Author

Daniele R. Giacobbe, Andrea Cortegiani, Ilias Karaiskos, Toine Mercier, Sofia Tejada, Maddalena Peghin, Cecilia Grecchi, Chiara Rebuffi, Erika Asperges, Valentina Zuccaro, Luigia Scudeller, Matteo Bassetti, and the FUNDICU investigators

Subjects
pneumocystis, PJP, diagnosis, biomarker, IFD, invasive fungal diseases, Biology (General), QH301-705.5
Abstract

The Fungal Infections Definitions in Intensive Care Unit (ICU) patients (FUNDICU) project aims to provide standard sets of definitions for invasive fungal diseases (IFDs) in critically ill, adult patients, including invasive aspergillosis (IA), invasive candidiasis (IC), Pneumocystis jirovecii pneumonia (PJP), and other non-IA, non-IC IFDs. The first step of the project was the conduction of separated systematic reviews of the characteristics and applicability to critically ill, adult patients outside classical populations at risk (hematology patients, solid organ transplant recipients) of available definitions and diagnostic tests for IFDs. We report here the results of two systematic reviews exploring the performance of available definitions and tests, for PJP and for other non-IA, non-IC IFDs. Starting from 2585 and 4584 records for PJP and other IFDs, respectively, 89 and 61 studies were deemed as eligible for full-text evaluation. However, only two studies for PJP and no studies for other IFDs met the FUNDICU protocol criteria for inclusion in qualitative synthesis. Currently, there is no sufficient solid data for directly evaluating the performance of existing definitions and laboratory tests for the diagnosis of PJP and other non-IA, non-IC IFDs in critically ill adult patients outside classical populations at risk.

Published
2021
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3. Performance of existing definitions and tests for the diagnosis of invasive aspergillosis in critically ill, non-neutropenic, adult patients: An update including COVID-19 data

Author

NVIC bedrijfsvoering, Brain, Medische Staf Intensive Care, Infection & Immunity, Bassetti, Matteo, Zuccaro, Valentina, Asperges, Erika, Scudeller, Luigia, Giacobbe, Daniele Roberto, FUNDICU investigators (collaborators), NVIC bedrijfsvoering, Brain, Medische Staf Intensive Care, Infection & Immunity, Bassetti, Matteo, Zuccaro, Valentina, Asperges, Erika, Scudeller, Luigia, Giacobbe, Daniele Roberto, and FUNDICU investigators (collaborators)

Published
2022

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

Author

NVIC bedrijfsvoering, Brain, Medische Staf Intensive Care, Infection & Immunity, Giacobbe, Daniele Roberto, Asperges, Erika, Cortegiani, Andrea, Grecchi, Cecilia, Rebuffi, Chiara, Zuccaro, Valentina, Scudeller, Luigia, Bassetti, Matteo, FUNDICU investigators, NVIC bedrijfsvoering, Brain, Medische Staf Intensive Care, Infection & Immunity, Giacobbe, Daniele Roberto, Asperges, Erika, Cortegiani, Andrea, Grecchi, Cecilia, Rebuffi, Chiara, Zuccaro, Valentina, Scudeller, Luigia, Bassetti, Matteo, and FUNDICU investigators

Published
2022

5. 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

Author

Giacobbe, Daniele Roberto, Asperges, Erika, Cortegiani, Andrea, Grecchi, Cecilia, Rebuffi, Chiara, Zuccaro, Valentina, Scudeller, Luigia, Bassetti, Matteo FUNDICU investigators: Murat Akova, Ana, Alastruey-Izquierdo, Sevtap, Arikan-Akdagli, Elie, Azoulay, Stijn, I Blot, Oliver, A Cornely, Cornelia, Lass-Flörl, Philipp, Koehler, Manuel, Cuenca-Estrella, Dylan, W de Lange, Francesco, G De Rosa, Jan, J De Waele, George, Dimopoulos, José, Garnacho-Montero, Martin, Hoenigl, Souha, S Kanj, Frederic, Lamoth, Johan, Maertens, Ignacio, Martin-Loeches, Patricia, Muñoz, Bart, J Kullberg, Christina, Agvald-Ohman, Garyphallia, Poulakou, Jordi, Rello, Maurizio, Sanguinetti, Fabio, S Taccone, Jean-François, Timsit, Antoni, Torres, Jose, A Vazquez, Joost, Wauters, Thierry, Calandra, Sofia, Tejada, Ilias, Karaiskos, Peghin, Maddalena, Antonio, Vena, Klaus, L Mortensen, Clement, Lebihan, Toine Mercier Affiliations, Giacobbe, Daniele Roberto, Asperges, Erika, Cortegiani, Andrea, Grecchi, Cecilia, Rebuffi, Chiara, Zuccaro, Valentina, Scudeller, Luigia, and Bassetti, Matteo

Subjects
Adult, Antifungal Agents, Critical Care, diagnosis, Critical Illness, candidemia, Dermatology, General Medicine, invasive candidiasis, IC, Intensive Care Units, Infectious Diseases, Candida, biomarker, candidaemia, deep-seated candidiasis, Humans, Candidiasis, Invasive, Prospective Studies
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 summarize 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.

Published
2022

7. Performance of existing definitions and tests for the diagnosis of invasive aspergillosis in critically ill, adult patients: A systematic review with qualitative evidence synthesis

Author

NVIC bedrijfsvoering, Brain, Medische Staf Intensive Care, Infection & Immunity, Bassetti, M, Giacobbe, D R, Grecchi, C, Rebuffi, C, Zuccaro, V, Scudeller, L, FUNDICU investigators, NVIC bedrijfsvoering, Brain, Medische Staf Intensive Care, Infection & Immunity, Bassetti, M, Giacobbe, D R, Grecchi, C, Rebuffi, C, Zuccaro, V, Scudeller, L, and FUNDICU investigators

Published
2020

8. Performance of existing definitions and tests for the diagnosis of invasive aspergillosis in critically ill, adult patients: A systematic review with qualitative evidence synthesis.

Author

Bassetti, M., Giacobbe, D.R., Grecchi, C., Rebuffi, C., Zuccaro, V., Scudeller, L., and FUNDICU investigators

Abstract

Objectives: To summarize the available evidence on the diagnostic performance for invasive aspergillosis (IA) in non-hematological, non-solid organ transplantation critically ill patients of the following: (i) existing definitions of IA (developed either for classical immunocompromised populations or for non-immunocompromised critically ill patients); (ii) laboratory tests; (iii) radiology tests.Methods: A systematic review was performed by evaluating studies assessing the diagnostic performance for IA of a definition/s and/or laboratory/radiology test/s vs. a reference standard (histology) or a reference definition.Results: Sufficient data for evaluating the performance of existing definitions and laboratory tests for the diagnosis of IA in critically ill patients is available only for invasive pulmonary aspergillosis. Against histology/autopsy as reference, the AspICU definition showed a promising diagnostic performance but based on small samples and applicable only to patients with positive respiratory cultures. Studies on laboratory tests consistently indicated a better diagnostic performance of bronchoalveolar lavage fluid (BALF) galactomannan (GM) than serum GM, and a suboptimal specificity of BALF and serum (1,3)-β-D-glucan.Conclusions: Evidence stemming from this systematic review will guide the discussion for defining invasive aspergillosis within the FUNDICU project. The project aims to develop a standard set of definitions for invasive fungal diseases in critically ill, adult patients. [ABSTRACT FROM AUTHOR]

Published
2020
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9. Performance of existing definitions and tests for the diagnosis of invasive aspergillosis in critically ill, non-neutropenic, adult patients: An update including COVID-19 data

Author

Matteo Bassetti, Valentina Zuccaro, Erika Asperges, Luigia Scudeller, Daniele Roberto Giacobbe, M. Akova, A. Alastruey-Izquierdo, S. Arikan-Akdagli, E. Azoulay, S. Blot, A. Cortegiani, O.A. Cornely, C. Grecchi, C. Lass-Flörl, P. Koehler, M. Cuenca-Estrella, D.W. de Lange, F.G. De Rosa, J.J. De Waele, G. Dimopoulos, J. Garnacho-Montero, M. Hoenigl, S.S. Kanj, F. Lamoth, J. Maertens, I. Martin-Loeches, P. Muñoz, B.J. Kullberg, C. Agvald-Ohman, G. Poulakou, C. Rebuffi, J. Rello, M. Sanguinetti, F.S. Taccone, J-F. Timsit, A. Torres, J.A. Vazquez, J. Wauters, T. Calandra, S. Tejada, I. Karaiskos, M. Peghin, A. Vena, K.L. Mortensen, C. Lebihan, T. Mercier, Bassetti, Matteo, Zuccaro, Valentina, Asperges, Erika, Scudeller, Luigia, Giacobbe, Daniele Roberto, and FUNDICU investigators (collaborators): M Akova, A Alastruey-Izquierdo, S Arikan-Akdagli, E Azoulay, S Blot, A Cortegiani, O A Cornely, C Grecchi, C Lass-Flörl, P Koehler, M Cuenca-Estrella, D W de Lange, F G De Rosa, J J De Waele, G Dimopoulos, J Garnacho-Montero, M Hoenigl, S S Kanj, F Lamoth, J Maertens, I Martin-Loeches, P Muñoz, B J Kullberg, C Agvald-Ohman, G Poulakou, C Rebuffi, J Rello, M Sanguinetti, F S Taccone, J-F Timsit, A Torres, J A Vazquez, J Wauters, T Calandra, S Tejada, I Karaiskos, M Peghin, A Vena, K L Mortensen, C Lebihan, T Mercier

Subjects
Microbiology (medical), Adult, Invasive Pulmonary Aspergillosis, Intensive Care Units, Aspergillus, Infectious Diseases, COVID-19 Testing, Critical Illness, Aspergillosis, COVID-19, Humans, Settore MED/07 - MICROBIOLOGIA E MICROBIOLOGIA CLINICA, Invasive Fungal Infections
Published
2022

10. Performance of existing definitions and tests for the diagnosis of invasive fungal diseases other than invasive candidiasis and invasive aspergillosis in critically ill, adult patients : a systematic review with qualitative evidence synthesis

Author

Cornelia Lass-Flörl, Daniele Roberto Giacobbe, Valentina Zuccaro, Erika Asperges, Chiara Rebuffi, Luigia Scudeller, Toine Mercier, Stijn Blot, Ilias Karaiskos, Dylan De Lange, Frederic Lamoth, Maddalena Peghin, Oliver Cornely, Sofia Tejada, Ana Alastruey-Izquierdo, Giacobbe, Daniele R, Cortegiani, Andrea, Karaiskos, Ilia, Mercier, Toine, Tejada, Sofia, Peghin, Maddalena, Grecchi, Cecilia, Rebuffi, Chiara, Asperges, Erika, Zuccaro, Valentina, Scudeller, Luigia, Bassetti, Matteo, The Fundicu Investigators, null, Institut Català de la Salut, [Giacobbe DR] Department of Health Sciences, University of Genoa, 16132 Genoa, Italy. Clinica Malattie Infettive, Ospedale Policlinico San Martino–IRCCS, 16132 Genoa, Italy. [Cortegiani A] Department of Surgical, Oncological and Oral Science (Di.Chir.On.S.), University of Palermo, 90127 Palermo, Italy. Department of Anaesthesia Intensive Care and Emergency, Policlinico Paolo Giaccone, 90127 Palermo, Italy. [Karaiskos I] Hygeia General Hospital, 15123 Athens, Greece. [Mercier T] Department of Microbiology, Immunology and Transplantation, KU Leuven, 3000 Leuven, Belgium. Department of Hematology, University Hospitals Leuven, 3000 Leuven, Belgium. [Tejada S] Grup d’Investigació Clínica/Epidemiologia en Pneumònia i Sèpsia (CRIPS), Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, 28220 Madrid, Spain. [Peghin M] Infectious Diseases Division, Department of Medicine, University of Udine and Azienda Sanitaria Universitaria Integrata di Udine, 33100 Udine, Italy, and Vall d'Hebron Barcelona Hospital Campus

Subjects
diagnosis, infecciones bacterianas y micosis::micosis::infecciones fúngicas invasoras [ENFERMEDADES], invasive fungal diseases, PJP, Plant Science, Aspergillosis, Bacterial Infections and Mycoses::Mycoses::Invasive Fungal Infections [DISEASES], law.invention, 0302 clinical medicine, IFD, biomarker, pneumocystis, law, Diagnosis, Other subheadings::/diagnosis [Other subheadings], Medicine and Health Sciences, 030212 general & internal medicine, lcsh:QH301-705.5, 0303 health sciences, Natural Science Disciplines::Science::Research::Empirical Research::Qualitative Research [DISCIPLINES AND OCCUPATIONS], Ecology, Communication, Pneumocystis jirovecii Pneumonia, Invasive candidiasis, Intensive care unit, Invasive fungal diseases, Systematic review, Microbiology (medical), medicine.medical_specialty, Evolution, Qualitative evidence, Otros calificadores::/diagnóstico [Otros calificadores], Investigació qualitativa, 03 medical and health sciences, Behavior and Systematics, disciplinas de las ciencias naturales::ciencia::investigación::investigación empírica::investigación cualitativa [DISCIPLINAS Y OCUPACIONES], medicine, Intensive care medicine, Ecology, Evolution, Behavior and Systematics, Adult patients, 030306 microbiology, Critically ill, business.industry, Pneumocystis, Biomarker, medicine.disease, lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4], lcsh:Biology (General), Micosi - Diagnòstic, business
Abstract

Diagnòstic; Malalties fúngiques invasores; Pneumocystis Diagnóstico; Enfermedades fúngicas invasivas; Pneumocystis Diagnosis; Invasive fungal diseases; Pneumocystis The Fungal Infections Definitions in Intensive Care Unit (ICU) patients (FUNDICU) project aims to provide standard sets of definitions for invasive fungal diseases (IFDs) in critically ill, adult patients, including invasive aspergillosis (IA), invasive candidiasis (IC), Pneumocystis jirovecii pneumonia (PJP), and other non-IA, non-IC IFDs. The first step of the project was the conduction of separated systematic reviews of the characteristics and applicability to critically ill, adult patients outside classical populations at risk (hematology patients, solid organ transplant recipients) of available definitions and diagnostic tests for IFDs. We report here the results of two systematic reviews exploring the performance of available definitions and tests, for PJP and for other non-IA, non-IC IFDs. Starting from 2585 and 4584 records for PJP and other IFDs, respectively, 89 and 61 studies were deemed as eligible for full-text evaluation. However, only two studies for PJP and no studies for other IFDs met the FUNDICU protocol criteria for inclusion in qualitative synthesis. Currently, there is no sufficient solid data for directly evaluating the performance of existing definitions and laboratory tests for the diagnosis of PJP and other non-IA, non-IC IFDs in critically ill adult patients outside classical populations at risk. The present project did not require additional funding from routine research activities. Costs for open-access publications were covered by research funds of the main authors.

Published
2021

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