Multicenter retrospective development and validation of a clinical prediction rule for nosocomial invasive candidiasis in the intensive care setting.

Journal Article (Journal Article;Multicenter Study)

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.

Full Text

Duke Authors

Cited Authors

  • Ostrosky-Zeichner, L; Sable, C; Sobel, J; Alexander, BD; Donowitz, G; Kan, V; Kauffman, CA; Kett, D; Larsen, RA; Morrison, V; Nucci, M; Pappas, PG; Bradley, ME; Major, S; Zimmer, L; Wallace, D; Dismukes, WE; Rex, JH

Published Date

  • April 2007

Published In

Volume / Issue

  • 26 / 4

Start / End Page

  • 271 - 276

PubMed ID

  • 17333081

International Standard Serial Number (ISSN)

  • 0934-9723

Digital Object Identifier (DOI)

  • 10.1007/s10096-007-0270-z


  • eng

Conference Location

  • Germany