Back to Search
Start Over
Polymerase Chain Reaction Versus Blood Culture to Detect Candida Species in High-Risk Patients with Suspected Invasive Candidiasis: The MICAFEM Study
- Source :
- Infectious Diseases and Therapy, Vol 8, Iss 3, Pp 429-444 (2019), Scientia, Infectious Diseases and Therapy
- Publication Year :
- 2019
- Publisher :
- Adis, Springer Healthcare, 2019.
-
Abstract
- Introduction We evaluated the diagnostic reliability of serum polymerase chain reaction (PCR) versus blood culture, abdominal fluid or both (composite measure) in patients receiving empirical antifungal treatment for suspected invasive candidiasis. Methods This observational, prospective, non-interventional, multicentre study in Spain enrolled 176 critically ill patients admitted to the intensive care unit. Separate blood samples for culture and serum PCR were taken before the start of antifungal therapy. Patient assessment was performed according to each site’s usual clinical practice. The primary end point was concordance between serum PCR and blood culture. Secondary end points were concordance between serum PCR and a positive abdominal fluid sample or the composite measure. Quality indices included sensitivity, specificity, positive/negative predictive values (PPV/NPV) and kappa indices. Results Among 175 evaluable patients, rates of Candida detection were similar for serum PCR (n = 16/175, 9.1%) versus blood culture (n = 14/175, 8.0%). Quality indices for serum PCR relative to blood culture were: sensitivity 21.4%; specificity 91.9%; PPV 18.8%; NPV 93.1%; kappa index 0.125. Thirty-two abdominal fluid samples were positive. Quality indices for serum PCR versus abdominal fluid were: sensitivity 31.3%; specificity 83.0%; PPV 15.6%; NPV 92.3%; kappa index 0.100. Quality indices for serum PCR versus the composite measure were: sensitivity 15.8%; specificity 92.7%; PPV 37.5%; NPV 79.9%; kappa index 0.107. Conclusion The sensitivity of serum PCR for Candida detection was low and the rate of concordance was low between serum PCR and the other diagnostic techniques used to identify Candida infections. Hospital-based diagnostic tests need optimising to improve outcomes in patients with suspected invasive candidiasis. Funding Astellas Pharma Inc. Electronic supplementary material The online version of this article (10.1007/s40121-019-0248-z) contains supplementary material, which is available to authorized users.
- Subjects :
- 0301 basic medicine
Microbiology (medical)
medicine.medical_specialty
Concordance
030106 microbiology
Otros calificadores::/diagnóstico [Otros calificadores]
Gastroenterology
diagnóstico::técnicas y procedimientos diagnósticos::técnicas de laboratorio clínico::técnicas microbiológicas::hemocultivo [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS]
law.invention
lcsh:Infectious and parasitic diseases
Diagnosis::Diagnostic Techniques and Procedures::Clinical Laboratory Techniques::Microbiological Techniques::Blood Culture [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT]
03 medical and health sciences
0302 clinical medicine
Reacció en cadena de la polimerasa
law
Internal medicine
Empirical antifungal treatment
Other subheadings::/diagnosis [Other subheadings]
Clinical endpoint
Medicine
Intensive care unit
Blood culture
lcsh:RC109-216
030212 general & internal medicine
Candidiasis - Diagnòstic
Polymerase chain reaction
Original Research
técnicas de investigación::técnicas genéticas::técnicas de amplificación de ácidos nucleicos::reacción en cadena de la polimerasa [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS]
Candida
medicine.diagnostic_test
Abdominal Fluid
business.industry
Sang - Anàlisi
Bacterial Infections and Mycoses::Mycoses::Candidiasis::Candidiasis, Invasive [DISEASES]
Invasive candidiasis
medicine.disease
PCR
Infectious Diseases
Blood cultures
Investigative Techniques::Genetic Techniques::Nucleic Acid Amplification Techniques::Polymerase Chain Reaction [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT]
infecciones bacterianas y micosis::micosis::candidiasis::candidiasis invasiva [ENFERMEDADES]
Abdominal fluid
business
Kappa
Candida diagnosis
Subjects
Details
- Language :
- English
- ISSN :
- 21936382 and 21938229
- Volume :
- 8
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- Infectious Diseases and Therapy
- Accession number :
- edsair.doi.dedup.....4f1a713284963514977d5949fcca0da2
- Full Text :
- https://doi.org/10.1007/s40121-019-0248-z