Multicenter retrospective development and validation of a clinical prediction rule for nosocomial invasive candidiasis in the intensive care setting.
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| Abstract |
The study presented here was performed in order to create a rule that identifies subjects at high risk for invasive candidiasis in the intensive care setting. Retrospective review and statistical modelling were carried out on 2,890 patients who stayed at least 4 days in nine hospitals in the USA and Brazil; the overall incidence of invasive candidiasis in this group was 3% (88 cases). The best performing rule was as follows: Any systemic antibiotic (days 1-3) OR presence of a central venous catheter (days 1-3) AND at least TWO of the following-total parenteral nutrition (days 1-3), any dialysis (days 1-3), any major surgery (days -7-0), pancreatitis (days -7-0), any use of steroids (days -7-3), or use of other immunosuppressive agents (days -7-0). The rate of invasive candidiasis among patients meeting the rule was 9.9%, capturing 34% of cases in the units, with the following performance: relative risk 4.36, sensitivity 0.34, specificity 0.90, positive predictive value 0.01, and negative predictive value 0.97. The rule may identify patients at high risk of invasive candidiasis.
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| Authors | L Ostrosky-Zeichner, C Sable, J Sobel, B D Alexander, G Donowitz, V Kan, C A Kauffman, D Kett, R A Larsen, V Morrison, M Nucci, P G Pappas, M E Bradley, S Major, L Zimmer, D Wallace, W E Dismukes, J H Rex |
| Journal | European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology (Eur J Clin Microbiol Infect Dis) Vol. 26 Issue 4 Pg. 271-6 (Apr 2007) ISSN: 0934-9723 [Print] Germany |
| PMID | 17333081 (Publication Type: Journal Article, Multicenter Study, Research Support, N.I.H., Extramural) |
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