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MINERVA ANESTESIOLOGICA

A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care


Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
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ORIGINAL ARTICLES  CRITICAL AND INTENSIVE THERAPY


Minerva Anestesiologica 1999 September;65(9):637-9

language: English

Evaluation of the util­ity of ser­o­log­i­cal ­tests in the diag­no­sis of can­di­de­mia

Pallavicini F. 1, Izzi I. 1, Pennisi M. A. 2, Morace G. 3, Portaccio G. G. 1, Bello G. 2, Iodice F. 2, Godino D. 2, Del Borgo C. 1, Proietti R. 2

1 Istituto di Clinica ­delle Malattie Infettive, Università Cattolica del Sacro Cuore - Roma;
2 Istituto di Anestesiologia e Rianimazione, Università Cattolica del Sacro Cuore - Roma;
3 Istituto di Microbiologia, Università Cattolica del Sacro Cuore - Roma


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Background. It has ­been ­observed ­that the inci­dence and prev­a­lence of can­di­da infec­tions in crit­i­cal­ly ill non-immu­no­com­prom­ised ­patients has ­increased. This ­study ­aims to eval­u­ate the util­ity of the use of ser­o­log­i­cal ­tests (dou­ble immu­no­dif­fu­sion and Cand -Tec Test) for the deter­mi­na­tion of can­di­de­mia.
Methods. A ret­ro­spec­tive eval­u­a­tion­ is ­made of 214 ­patients admit­ted to the Intensive Care Unit (ICU) of the Agostino Gemelli University Polyclinic dur­ing a peri­od of 42 ­months. The dou­ble immu­no­dif­fu­sion tech­nique was uti­lized for the deter­mi­na­tion of Candida anti­bod­ies. The Cand-Tec ­latex agglu­ti­na­tion ­test was per­formed to eval­u­ate the pres­ence of Candida anti­gen. Four hun­dred and fif­ty-­five anti­gen and anti­body ­tests ­were per­formed.
Results. Thirty-six ­patients (16.8%) devel­oped an inva­sive can­di­di­a­sis. The sen­si­tiv­ity and spec­i­fic­ity of anti­body detec­tion ­test was 29 and 67 respec­tive­ly; the pos­i­tive pre­dic­tive val­ue was 15 and the neg­a­tive pre­dic­tive val­ue was 82. The sen­si­tiv­ity and spec­i­fic­ity of the anti­gen detec­tion ­test ­ranged ­between 82 and 3 and ­between 8 and 98 respec­tive­ly accord­ing to dif­fer­ent cut-off ­titre; the pos­i­tive pre­dic­tive val­ue was low (13-17%) and the neg­a­tive pre­dic­tive val­ue ­decreased ­from 70 to 29.
Conclusions. The util­ity of the use of ser­o­log­i­cal ­tests in the diag­no­sis of can­di­de­mia is extreme­ly lim­it­ed. The ­gold stan­dard for the deter­mi­na­tion of Candida sep­sis ­remains the dem­on­stra­tion of can­di­da in ­blood or in tis­sues.

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