Detection of Candida DNA in peritoneal fluids by PCR assay optimizing the diagnosis and treatment for intra-abdominal candidiasis in high-risk ICU patients: A prospective cohort study
BackgroundIntra-abdominal candidiasis (IAC) is the predominant type of invasive candidiasis with high mortality in critically ill patients. This study aimed to investigate whether the polymerase chain reaction (PCR) assay for detecting Candida DNA in peritoneal fluids (PF) is useful in diagnosing an...
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Frontiers Media S.A.
2023-01-01
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| Series: | Frontiers in Microbiology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmicb.2022.1070688/full |
| _version_ | 1828071072091602944 |
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| author | Min Xie Jin Shao Jin Shao Jin Shao Jin Shao Jin Shao Zhe Wan Zhe Wan Zhe Wan Zhe Wan Ting Yan Sainan Zhu Shuangling Li Jin Yu Jin Yu Jin Yu Jin Yu |
| author_facet | Min Xie Jin Shao Jin Shao Jin Shao Jin Shao Jin Shao Zhe Wan Zhe Wan Zhe Wan Zhe Wan Ting Yan Sainan Zhu Shuangling Li Jin Yu Jin Yu Jin Yu Jin Yu |
| author_sort | Min Xie |
| collection | DOAJ |
| description | BackgroundIntra-abdominal candidiasis (IAC) is the predominant type of invasive candidiasis with high mortality in critically ill patients. This study aimed to investigate whether the polymerase chain reaction (PCR) assay for detecting Candida DNA in peritoneal fluids (PF) is useful in diagnosing and management of IAC in high-risk patients in intensive care unit (ICU).MethodsA prospective single-center cohort study of surgical patients at high risk for IAC was conducted in the ICU. PF was collected from the abdominal drainage tubes (within 24 h) or by percutaneous puncture. Direct PF smear microscopy, PF culture, blood culture, and serum (1–3)-β-D-glucan were performed in all patients. For Candida PCR assay, the ITS1/ITS4 primers that targeted the ITS1-5.8 s-ITS2 regions were used for PCR, and sequencing analysis was used to identify the pathogen at the species level. IAC was defined according to the 2013 European consensus criteria.ResultsAmong 83 patients at high risk for IAC, the IAC criteria were present in 17 (20.5%). The sensitivity and specificity of the Candida PCR assay were 64.7 and 89.4%, respectively, and the area under the receiver operating characteristic curve was 0.77 (95% CI: 0.63–0.91). In this cohort, the positive predictive value and negative predictive value were 90.8% (95% CI: 80.3–96.2%) and 61.1% (95% CI: 36.1–81.7%), respectively. Diagnostic consistency was moderate (kappa 0.529, p < 0.001) according to the 2013 European consensus criteria.ConclusionDetection of Candida DNA in PF using PCR can be considered an adjunct to existing routine diagnostic tools which may optimize the diagnosis and antifungal treatment of IAC in high-risk patients in the ICU. |
| first_indexed | 2024-04-11T00:47:28Z |
| format | Article |
| id | doaj.art-0888758fc88442b88c1dd72932bc7056 |
| institution | Directory Open Access Journal |
| issn | 1664-302X |
| language | English |
| last_indexed | 2024-04-11T00:47:28Z |
| publishDate | 2023-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Microbiology |
| spelling | doaj.art-0888758fc88442b88c1dd72932bc70562023-01-05T12:46:25ZengFrontiers Media S.A.Frontiers in Microbiology1664-302X2023-01-011310.3389/fmicb.2022.10706881070688Detection of Candida DNA in peritoneal fluids by PCR assay optimizing the diagnosis and treatment for intra-abdominal candidiasis in high-risk ICU patients: A prospective cohort studyMin Xie0Jin Shao1Jin Shao2Jin Shao3Jin Shao4Jin Shao5Zhe Wan6Zhe Wan7Zhe Wan8Zhe Wan9Ting Yan10Sainan Zhu11Shuangling Li12Jin Yu13Jin Yu14Jin Yu15Jin Yu16Department of Critical Care Medicine, Peking University First Hospital, Peking University, Beijing, ChinaDepartment of Dermatology and Venerology, Peking University First Hospital, Beijing, ChinaResearch Center for Medical Mycology, Peking University, Beijing, ChinaBeijing Key Laboratory of Molecular Diagnosis of Dermatoses, Peking University First Hospital, Beijing, ChinaNational Clinical Research Center for Skin and Immune Diseases, Beijing, ChinaDepartment of Dermatology, Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, Tianjin, ChinaDepartment of Dermatology and Venerology, Peking University First Hospital, Beijing, ChinaResearch Center for Medical Mycology, Peking University, Beijing, ChinaBeijing Key Laboratory of Molecular Diagnosis of Dermatoses, Peking University First Hospital, Beijing, ChinaNational Clinical Research Center for Skin and Immune Diseases, Beijing, ChinaDepartment of Critical Care Medicine, Peking University First Hospital, Peking University, Beijing, ChinaDepartment of Biostatistics, Peking University First Hospital, Peking University, Beijing, ChinaDepartment of Critical Care Medicine, Peking University First Hospital, Peking University, Beijing, ChinaDepartment of Dermatology and Venerology, Peking University First Hospital, Beijing, ChinaResearch Center for Medical Mycology, Peking University, Beijing, ChinaBeijing Key Laboratory of Molecular Diagnosis of Dermatoses, Peking University First Hospital, Beijing, ChinaNational Clinical Research Center for Skin and Immune Diseases, Beijing, ChinaBackgroundIntra-abdominal candidiasis (IAC) is the predominant type of invasive candidiasis with high mortality in critically ill patients. This study aimed to investigate whether the polymerase chain reaction (PCR) assay for detecting Candida DNA in peritoneal fluids (PF) is useful in diagnosing and management of IAC in high-risk patients in intensive care unit (ICU).MethodsA prospective single-center cohort study of surgical patients at high risk for IAC was conducted in the ICU. PF was collected from the abdominal drainage tubes (within 24 h) or by percutaneous puncture. Direct PF smear microscopy, PF culture, blood culture, and serum (1–3)-β-D-glucan were performed in all patients. For Candida PCR assay, the ITS1/ITS4 primers that targeted the ITS1-5.8 s-ITS2 regions were used for PCR, and sequencing analysis was used to identify the pathogen at the species level. IAC was defined according to the 2013 European consensus criteria.ResultsAmong 83 patients at high risk for IAC, the IAC criteria were present in 17 (20.5%). The sensitivity and specificity of the Candida PCR assay were 64.7 and 89.4%, respectively, and the area under the receiver operating characteristic curve was 0.77 (95% CI: 0.63–0.91). In this cohort, the positive predictive value and negative predictive value were 90.8% (95% CI: 80.3–96.2%) and 61.1% (95% CI: 36.1–81.7%), respectively. Diagnostic consistency was moderate (kappa 0.529, p < 0.001) according to the 2013 European consensus criteria.ConclusionDetection of Candida DNA in PF using PCR can be considered an adjunct to existing routine diagnostic tools which may optimize the diagnosis and antifungal treatment of IAC in high-risk patients in the ICU.https://www.frontiersin.org/articles/10.3389/fmicb.2022.1070688/fullintra-abdominal candidiasisPCR assayCandida spp.intensive care unitperitoneal fluid |
| spellingShingle | Min Xie Jin Shao Jin Shao Jin Shao Jin Shao Jin Shao Zhe Wan Zhe Wan Zhe Wan Zhe Wan Ting Yan Sainan Zhu Shuangling Li Jin Yu Jin Yu Jin Yu Jin Yu Detection of Candida DNA in peritoneal fluids by PCR assay optimizing the diagnosis and treatment for intra-abdominal candidiasis in high-risk ICU patients: A prospective cohort study Frontiers in Microbiology intra-abdominal candidiasis PCR assay Candida spp. intensive care unit peritoneal fluid |
| title | Detection of Candida DNA in peritoneal fluids by PCR assay optimizing the diagnosis and treatment for intra-abdominal candidiasis in high-risk ICU patients: A prospective cohort study |
| title_full | Detection of Candida DNA in peritoneal fluids by PCR assay optimizing the diagnosis and treatment for intra-abdominal candidiasis in high-risk ICU patients: A prospective cohort study |
| title_fullStr | Detection of Candida DNA in peritoneal fluids by PCR assay optimizing the diagnosis and treatment for intra-abdominal candidiasis in high-risk ICU patients: A prospective cohort study |
| title_full_unstemmed | Detection of Candida DNA in peritoneal fluids by PCR assay optimizing the diagnosis and treatment for intra-abdominal candidiasis in high-risk ICU patients: A prospective cohort study |
| title_short | Detection of Candida DNA in peritoneal fluids by PCR assay optimizing the diagnosis and treatment for intra-abdominal candidiasis in high-risk ICU patients: A prospective cohort study |
| title_sort | detection of candida dna in peritoneal fluids by pcr assay optimizing the diagnosis and treatment for intra abdominal candidiasis in high risk icu patients a prospective cohort study |
| topic | intra-abdominal candidiasis PCR assay Candida spp. intensive care unit peritoneal fluid |
| url | https://www.frontiersin.org/articles/10.3389/fmicb.2022.1070688/full |
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