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Clinical and management utility of Candida albicans germ tube antibody detection in critically ill patients. Influence on mortality

Abstract number: P1345

Zaragoza R., Pemán J., Quindós G., Iruretagoyena J., Cuétara M., Ramirez P., Alkorta M., Camarena J., Viudes A., Pontón J.

Background: Invasive candidiasis in critically ill patients represents a diagnostic challenge. Recently, an immunofluorescence test for Candida germ tube antibody (CAGTA) detection has been marketed. The aims of the present study were to determine the prevalence of CAGTA in an ICU setting, the clinical and management utility of its detection, and the influence of a strategy based on early determination of CAGTA on mortality in a selected ICU population.

Methods: A prospective and observational multicentre study was developed in six Spanish University hospitals during 2005. CAGTA test was performed twice a week if predetermined risk factors were present, and a positive result was considered if the testing serum dilution was equal or higher than 1:160 in at least one sample. Clinical, microbiological and outcome variables were recorded. A multivariate analysis was performed to assess the influence of this technique on mortality.

Results: Fifty-three critically ill patients non-neutropenic (37.7% post surgery) were included. Twenty-two patients (41.5%) had CAGTA-positive results, none of them with positive blood culture for Candida. The intra ICU mortality rate was significantly lower (p = 0.004) in positive CAGTA patients (61.2% vs. 22.7%). A multivariate analysis confirmed a CAGTA-positive result as the only protective factor independently associated with ICU mortality (beta coefficient = -0.3856; 95%IC: -0.648; -0.123).

Conclusions: The rate of CAGTA-positive results in a selected group of ICU patients is high. A strategy based on early determination of CAGTA might reduce the ICU mortality of patients with risk factors to develop invasive candidiasis.

Session Details

Date: 19/04/2008
Time: 00:00-00:00
Session name: 18th European Congress of Clinical Microbiology and Infectious Diseases
Subject:
Location: Barcelona, Spain
Presentation type:
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