Performance of a Quantitative PCR-Based Assay and Beta-d-Glucan Detection for Diagnosis of Invasive Candidiasis in Very-Low-Birth-Weight Preterm Neonatal Patients (CANDINEO Study).
Por:
Ramos JT, Villar S, Bouza E, Bergon-Sendin E, Perez Rivilla A, Collados CT, Andreu M, Reyes CS, Campos-Herrero MI, de Heredia JL, Herrera MCL, Alonso PA, Pallás-Alonso CR, Cuenca-Estrella M and CANDINEO Study Group
Publicada:
1 sep 2017
Ahead of Print:
28 jun 2017
Categoría:
Microbiology (medical)
Resumen:
An epidemiological, multicenter, noninterventional, observational case-control study was conducted to describe the performance of serum beta-d-glucan (BDG) and Candida PCR in blood, serum, and sterile samples for the diagnosis of invasive candidiasis (IC) in very-low-birth-weight (VLBW) preterm neonates and to compare these techniques with culture of samples from blood and other sterile sites. Seventeen centers participated in the study, and the number of episodes analyzed was 159. A total of 9 episodes of IC from 9 patients (7 confirmed and 2 probable) and 150 episodes of suspected sepsis from 117 controls were identified. The prevalence of IC was 5.7% (95% confidence interval [95% CI], 2.1 to 9.3). The mortality was significantly higher in episodes of IC (44.4%) than in the non-IC episodes (11.1%, P < 0.01). The sensitivity and specificity of the PCR performed on blood/serum samples were 87.5% and 81.6%, respectively. The sensitivity and specificity of the BDG results were lower (75.0% and 64.6%). For cases with negative culture results, the PCR and the BDG results were positive in 27 (17.4%) and 52 (33.5%) episodes, respectively. The presence of multiorgan failure, improvement with empirical antifungal therapy, thrombocytopenia, and Candida colonization were significantly associated (P < 0.01) with PCR or BDG positivity regardless of the results of the cultures. Serum BDG analysis and Candida PCR could be used as complementary diagnostic techniques to detect IC in VLBW neonates.
Filiaciones:
Ramos JT:
Hospital Universitario Clínico San Carlos, Departamento de Pediatría, and Universidad Complutense, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
Villar S:
Hospital Materno-Infantil Gregorio Marañón, Servicio de Neonatología, Madrid, Spain
Bouza E:
Hospital General Universitario Gregorio Marañón CIBERES, IISGM Universidad Complutense de Madrid, Madrid, Spain
Bergon-Sendin E:
Hospital Universitario 12 de Octubre, Servicio de Neonatología, Universidad Complutense, and Red de Salud Materno Infantil y del Desarrollo SAMID, Madrid, Spain
Perez Rivilla A:
Hospital Universitario 12 de Octubre, Servicio de Microbiología, Madrid, Spain
:
Hospital General Universitario de Alicante, Servicio de Neonatología, Alicante, Spain
:
Hospital General Universitario de Alicante, Servicio de Microbiología, Alicante, Spain
Reyes CS:
Hospital Materno-Infantil Insular de Las Palmas, Servicio de Neonatología, Las Palmas de Gran Canaria, Spain
Campos-Herrero MI:
Hospital Universitario de Gran Canaria Doctor Negrín, Hospital Materno-Infantil, Servicio de Microbiología, Las Palmas de Gran Canaria, Spain
de Heredia JL:
Hospital de Cruces, Servicio de Neonatología, Bilbao, Spain
Herrera MCL:
Hospital de Cruces, Servicio de Neonatología, Bilbao, Spain
Alonso PA:
Astellas Pharma S.A., Madrid, Spain
Pallás-Alonso CR:
Hospital Universitario 12 de Octubre, Servicio de Neonatología, Universidad Complutense, and Red de Salud Materno Infantil y del Desarrollo SAMID, Madrid, Spain
Cuenca-Estrella M:
Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
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