Projects & Grants
| Early diagnosis of invasive candidiasis in intensive care | |
|---|---|
| Project Id | SGS06/LF/2024 |
| Main solver | Mgr. Radim Dobiáš, Ph.D. |
| Period | 1/2024 - 12/2024 |
| Provider | Specifický VŠ výzkum |
| State | solved |
| Anotation | Invasive candidiasis (IC) is the most frequent mycotic infection caused by diverse Candida species, comprising candidemia and deep-seated candidiasis with or without concomitant candidemia. The most critical risk groups are patients in the intensive care unit (ICU) and those undergoing repeated or complicated abdominal surgery. Candidemia is still associated with an overall ~40% mortality among septic patients in the ICU. In clinical practice, more strategies use various fungal biomarkers for the early prediction of IC. Panfungal test 1,3-ß-D-glucan cannot distinguish candidiasis and other fungal infections. Despite the high sensitivity for IC, the specificity notably varies, and multiple sources for false positivity have been reported, many of which are particularly challenging in the ICU and may lead to an inappropriate antifungal therapy of patients without IC. The combined sensitivity and specificity of the T2Candida molecular test for early detection of candidemia against blood culture are 91 % and 99 %, respectively. However, if the cases with IC without concomitant candidemia (deep-seated abdominal candidiasis) were tested, a significant decrease of the T2Candida sensitivity and specificity dropped to 55-59 %. This might be due to a threshold uncertainty definition. A successful diagnostic algorithm for early prediction of IC is still being sought, and for high reliability, it is necessary to use a combination of tests. The study can define new biomarkers, smart antifungal therapy, and better survival prognosis in critically ill patients. |
