“…The results indicate that ICU patients exposed to extensive gastro-abdominal surgery would benefit from early antifungal prophylaxis”Massou et al [55] | Medical ICU, stay >2 days and at least one risk factor; prospective | 100 | 15 | At admission, then weekly | 816 (including 143 blood cultures) | CI ≥ 0.5 in 53 (53 %), predicted only by corticosteroids [OR, 5.1 (1.02–25.2)] Accuracy of CI > 0.5 in predicting IC: sens, 93 %; spec, 48 %; PPV, 26 %; NPV, 98 % Only neutropenia predicted invasive candidiasis [OR, 18.3 (2.9–114)] | “CI has the advantage to provide quantified data of the patient’s situation in relation to the colonization. But, it isn’t helpful with patients having an invasive candidiasis in medical intensive care unit” |
Candiduria studies ( n = 5) |
Chabasse [56] | 15 mixed ICUs, one major or two minor risk factors and candiduria; prospective | 135 | 0 | At time of candiduria and/or candidemia | Not available | Candiduria: <10 3 , 56 (42 %); 10 3 –10 4 , 21 (16 %); >10 4 , 56 (42 %) CI > 0.5 in 36/76 tested (65 % with candiduria >10 4 , 31 % with candiduria <10 4 ; p = 0.003) | “Quantification of candiduria could be useful to select patients at high risk for disseminated candidiasis” |
Dubau et al [57] | Surgical ICU, stay or antibiotics >7 days or postoperative fistula and CRP > 100 mg/ml; prospective | 89 | 1/35 empirically treated with CIs ≥ 0.5; 0 with CIs < 0.5; 22 candiduria | On inclusion, then weekly | 2,238 | Absence of candiduria: CI = 0.3–0.47 ( p = 0.008) Presence of candiduria: CI = 0.57–0.87 ( p = 0.0001) | “The presence of a candiduria was significantly associated with an increased invasive candidiasis” |
Sellami et al [58] | Mixed ICU, stay >3 days; prospective | 162 | 6; 56 candiduria | On inclusion, then weekly | Not available | Candiduria: <10 3 , 12 (21 %); 10 3 –10 4 , 16 (29 %); >10 4 , 28 (50 %) Mean CI = 0.47 candiduria, 0.8 IC ( n = 6) CI > 0.5 in 67 % candiduria >10 4
| “Candiduria superior or equal to 10 4 UFC/ml associated with risk factors may predict invasive candidiasis in critically ill patients” |
Charles et al [38] | Medical ICU, stay > 7 days; prospective | 92 | 9 | Weekly | 1,696 (mean, 18.4/patient) | |
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