[Diagnostic methods in candidemia: a systematic review of literature with meta-analysis]

Rev Chilena Infectol. 2011 Oct;28(5):423-8. Epub 2011 Oct 19.
[Article in Spanish]

Abstract

Candidemia is a disease with high morbidity and mortality especially in critical care patients. Early diagnosis enables early treatment.

Objectives: To conduct a systematic review of the literature in order to establish the best laboratory tests for the diagnosis of candidemia in critical patients.

Materials and methods: We conducted a systematic review of available literature in PubMed. Serological studies were subjected to meta-analysis in metadisk-Beta 1.1.1.

Results: 4 studies of 1286 reviewed were included. Three were about serological tests and one about molecular testing (RT-PCR). The sensitivity and specificity for RT-PCR, antibody testing and antigen and antibody tests were 87% and 100%, 47.5% and 82.6%, 96% and 81%, respectively. Diagnostic Odds Ratio of antigenemia was 1.51 (95% CI = 0,032-70,964, p = 0.001).

Conclusions: RT-PCR has better diagnostic performance, measuring antigenemia plus antibodies improves sensitivity, specificity, LR + and LR-- . There is insufficient evidence to support this.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Antibodies, Fungal / blood
  • Antigens, Fungal / blood
  • Candida / genetics
  • Candida / immunology
  • Candidemia / diagnosis*
  • Critical Illness
  • Cross Infection / diagnosis*
  • Cross Infection / microbiology
  • Humans
  • Intensive Care Units
  • Real-Time Polymerase Chain Reaction
  • Sensitivity and Specificity

Substances

  • Antibodies, Fungal
  • Antigens, Fungal