Clinical validation of a multiplex real-time PCR assay for detection of invasive candidiasis in intensive care unit patients
Abstract
BACKGROUND: New techniques, such as those based on multiplex quantitative real-time PCR (MRT-PCR), can improve the detection of invasive candidiasis (IC). METHODS: We prospectively studied 63 intensive care unit patients with suspected IC and 40 healthy controls. Blood cultures and MRT-PCR were performed at day 0 and +2, +7, +14 and +21 days in all patients. In addition, β-d-glucan (BDG) and Candida albicans germ tube antibody (CAGTA) were quantified. RESULTS: IC was confirmed in 27 patients. Colonization was significantly higher in patients with IC (96% versus 64%, P = 0.002). The sensitivity, specificity, positive predictive value and negative predictive value of MRT-PCR for the diagnosis of IC were 96.3%, 97.3%, 92.8% and 98.7%, respectively. The positive predictive value and specificity were significantly higher for MRT-PCR than for BDG and CATGA. MRT-PCR performed very well, especially in deep-seated IC (sensitivity 90.9% versus 45.4% for blood culture; P = 0.06). As regards the most appropriate clinical sample for DNA amplification, in this study whole blood and serum presented similar results. CONCLUSIONS: MRT-PCR appears to be a useful test for confirming a diagnosis of IC in critically ill patients, especially in those with deep-seated disease. Its high sensitivity and positive predictive value make it a much more efficient tool for the management of IC than other diagnostic procedures and clinical scores.
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Standard diagnostic approaches require blood cultures, which are slow and can have low sensitivity, with some studies reporting sensitivities as low as 17% or 45%.
“standard diagnostic approaches require blood cultures, which are slow and can have a low sensitivity. For instance, some studies reported sensitivities as low as 17% [7] or 45% [8].”
From Evolutionary Emergence of Drug Resistance in Candida Opportunistic Pathogens (2018) · cites this paper as [8]
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- Authors
- Fortun, J., Meije, Y., Buitrago, M. J., Gago, S., Bernal-Martinez, L., Peman, J., Perez, M., Gomez-G Pedrosa, E., Madrid, N., Pintado, V., Martin-Davila, P., Cobo, J., Fresco, G., Moreno, S., & Cuenca-Estrella, M.
- Affiliations
- Instituto Ramón y Cajal de Investigación Sanitaria (ES)
- Centro Nacional de Microbiologia (ES)
- Venue
- Journal of Antimicrobial Chemotherapy
- Publisher
- Oxford University Press (OUP)
- Published
- 2014-06-25
- Volume
- 69
- Issue
- 11
- Pages
- 3134-3141
- ISSN
- 0305-7453 (ISSN-L)
- 1460-2091
- OpenAlex
- W2103318182
- Cited by
- 61
- References
- 32
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 2 · 2023: 4 · 2022: 5 · 2021: 7 · 2020: 1 · 2019: 9 · 2018: 9 · 2017: 5 · 2016: 5 · 2015: 5 · 2014: 4
- FWCI
- 4.44
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Antimicrobial Chemotherapy (publishedVersion)
- PubMed (publishedVersion)
- Research Explorer (The University of Manchester) (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Clinical Biochemistry › Bacterial Identification and Susceptibility Testing
- Health Sciences › Medicine › Epidemiology › Infective Endocarditis Diagnosis and Management
- Keywords
- invasive candidiasis, multiplex real-time PCR, Candida detection, intensive care unit patients, critically ill patients, sensitivity and specificity, blood culture comparison, beta-D-glucan, Candida colonization
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Child, Child, Preschool, Female, Humans, Infant, Intensive Care Units, Male, Middle Aged, Young Adult, Candidiasis, Invasive, Real-Time Polymerase Chain Reaction
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