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Description

Zhang et al reported a risk score for invasive candidiasis in an adult in the intensive care unit (ICU). The authors are from the Chinese Academy of Medical Sciences and Peking Union Medical College in Beijing.


Patient selection: adult in ICU >= 48 hours with clinical signs of infection

Exclusions: pregnant, lactating, neutropenia, other fungal infection

 

Parameters:

(1) absolute CD8 positive T cell count per microliter

(2) receipt of high-dose corticosteroids (>= 50 mg prednisolone equivalent)

(3) therapy with carbapenem/tigecycline

(4) APACHE II score

(5) blood test for BDG = (1,3)-beta-D-glycan

(6) emergency gastrointestinal, hepatic, pancreatic or biliary surgery

 

Parameter

Finding

Points

absolute CD8 T cell count

> 143 per µL

0

 

<= 143 per µL

1

high dose steroids

no

0

 

yes

1

carbapenem/tigecycline

no

0

 

yes

1

APACHE II

< 15

0

 

>= 15

1

blood test BDG

negative

0

 

positive

1

emergency GI/HPB surgery

no

0

 

yes

2

 

total score =

= SUM(points for all of the parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 7

 

Total Score

Rosl of Invasive Candidiasis

Percent

0 to 2

low

1-2%

3 or 4

moderate

12-13%

5 to 7

high

25-34%

 

Perforamnce:

• The area under the ROC curve is 0.82.


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