INTRODUCTION:
To evaluate predictive indices for
candidemia in an
adult intensive care unit (ICU) and to propose a new index.
METHODS:
A prospective
cohort study was conducted between January 2011 and December 2012. This study was performed in an ICU in a
tertiary care hospital at a public
university and included 114
patients staying in the
adult ICU for at least 48 hours. The
association of
patient variables with
candidemia was analyzed.
RESULTS:
There were 18 (15.8%) proven cases of
candidemia and 96 (84.2%) cases without
candidemia. Univariate
analysis revealed the following
risk factors parenteral nutrition,
severe sepsis,
surgical procedure,
dialysis,
pancreatitis, acute renal failure, and an
APACHE II score higher than 20. For the
Candida score index, the
odds ratio was 8.50 (95% CI, 2.57 to 28.09); the
sensitivity,
specificity,
positive predictive value, and
negative predictive value were 0.78, 0.71, 0.33, and 0.94, respectively. With
respect to the clinical predictor index, the
odds ratio was 9.45 (95%CI, 2.06 to 43.39); the
sensitivity,
specificity,
positive predictive value, and
negative predictive value were 0.89, 0.54, 0.27, and 0.96, respectively. The proposed
candidemia index cutoff was 8.5; the
sensitivity,
specificity,
positive predictive value, and
negative predictive value were 0.77, 0.70, 0.33, and 0.94, respectively.
CONCLUSIONS:
The
Candida score and clinical predictor index excluded
candidemia satisfactorily. The
effectiveness of the
candidemia index was comparable to that of the
Candida score. .