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dc.contributorVall d'Hebron Barcelona Hospital Campus
dc.contributor.authorNieto, Mercedes
dc.contributor.authorRobles, Juan Carlos
dc.contributor.authorCausse, Manuel
dc.contributor.authorGutiérrez, Leticia
dc.contributor.authorCruz Perez, Maria
dc.contributor.authorFerrer Roca, Ricard
dc.date.accessioned2019-07-16T05:35:48Z
dc.date.available2019-07-16T05:35:48Z
dc.date.issued2019-05-24
dc.identifier.citationNieto M, Robles JC, Causse M, Gutiérrez L, Cruz Perez M, Ferrer R, et al. Polymerase Chain Reaction Versus Blood Culture to Detect Candida Species in High-Risk Patients with Suspected Invasive Candidiasis: The MICAFEM Study. Infect Dis Ther. 2019;1–16.
dc.identifier.issn2193-6382
dc.identifier.urihttp://hdl.handle.net/11351/4188
dc.descriptionAbdominal fluid; Blood cultures; Candida
dc.description.abstractWe 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.
dc.language.isoeng
dc.publisherSpringer
dc.relation.ispartofseriesInfectious Diseases and Therapy;
dc.rightsAttribution-NonCommercial-NoDerivatives 4.0 International
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/
dc.sourceScientia
dc.subjectCandidiasis - Diagnòstic
dc.subjectReacció en cadena de la polimerasa
dc.subjectSang - Anàlisi
dc.subject.meshCandidiasis, Invasive
dc.subject.mesh/diagnosis
dc.subject.meshPolymerase Chain Reaction
dc.subject.meshBlood Culture
dc.titlePolymerase Chain Reaction Versus Blood Culture to Detect Candida Species in High-Risk Patients with Suspected Invasive Candidiasis: The MICAFEM Study
dc.typeinfo:eu-repo/semantics/article
dc.identifier.doi10.1007/s40121-019-0248-z
dc.subject.decscandidiasis invasiva
dc.subject.decs/diagnóstico
dc.subject.decsreacción en cadena de la polimerasa
dc.subject.decshemocultivo
dc.relation.publishversionhttps://link.springer.com/article/10.1007%2Fs40121-019-0248-z
dc.type.versioninfo:eu-repo/semantics/publishedVersion
dc.audienceProfessionals
dc.contributor.organismesInstitut Català de la Salut
dc.contributor.authoraffiliation[Nieto M] Hospital Clínico San Carlos, Madrid, Spain. [Robles JC, Causse M] Hospital Reina Sofía, Córdoba, Spain. [Gutiérrez L, Cruz Perez M] Hospital Universitario Son Llatzer, Palma de Mallorca, Spain. [Ferrer R] Catlab-Hospital Universitari Mutua Terrassa, Barcelona, Spain. Hospital Universitari Vall d'Hebron, Barcelona, Spain.
dc.identifier.pmid31127539
dc.rights.accessrightsinfo:eu-repo/semantics/openAccess


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