A Clinical Prediction Rule for Nosocomial Invasive Candidiasis in the ICU

The rule identified only one third of ICU patients who developed invasive candidiasis but performed better in predicting which patients were unlikely to be affected.

Nosocomial invasive candidiasis, a major complication in critically ill patients, increases morbidity, mortality, and costs. Unfortunately, it cannot be diagnosed easily because currently available tests lack sensitivity and specificity: For example, blood cultures are positive in <50% of cases. Therefore, antifungal therapy is commonly administered empirically, often leading to overtreatment. Now, researchers in 12 medical centers in the U.S. and Brazil have developed a clinical prediction rule to identify patients likely to develop invasive candidiasis.

Data for 2890 patients with hospital stays >4 days were used for statistical modeling. Eighty-eight (3%) of the patients had proven or probable invasive candidiasis (candida recovered from …

Reviewing Author

Thomas Glück, MD