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Assessment of clinical risk predictive rules for invasive candidiasis in a prospective multicentre cohort of ICU patients

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Abstract

Purpose

To assess the generalisability of published clinical risk predictive models for invasive candidiasis in ICU patients.

Methods

The performance characteristics of published clinical risk factor-only and Candida colonisation-only predictive models for invasive candidiasis were assessed in a multicentre cohort of Australian ICU patients. Clinical risk factors and Candida colonisation parameters were collected prospectively from patients.

Results

The two clinical risk factor-only predictive models applied to an Australian patient cohort (n = 615) performed less well than in published studies involving derivation populations. Model performance characteristics improved when Candida colonisation parameters were added post-hoc.

Conclusions

Risk predictive models should factor in both clinical risk factors and Candida colonisation parameters. Integrating these models into therapeutic algorithms first requires external validation in different patient populations and settings.

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Acknowledgments

This study was funded in part by a National Health and Medical Research Council Project Grant (512307) and Centre for Clinical Research Excellence Program Grant (264625), and an unrestricted grant from Pfizer Inc. None of the funding institutions were involved in the study design, data collection, analysis, or publication process. Members of the Prospective Surveillance of Invasive Fungal Infections in Australia ICUs Study Group are: Geoffrey Playford, Chris Joyce, Joan Faoagali, Neil Underwood, and Barbara Johnson (Princess Alexandra Hospital, Brisbane); Jeff Lipman, David Paterson, Graeme Nimmo, Cheryl Fourie, Janine Stuart, and Narelle George (Royal Brisbane and Women’s Hospital), Tania Sorrell, Jon Iredell, John Gallagher, Masrura Kabir, Claire Kesby, and Anna Lau (Westmead Hospital); Emma McBryde, Leanne Redl, and Caroline Marshall (Royal Melbourne Hospital); Kyra Chua, Ben Rogers, and Tom Schultz (Victorian Infectious Diseases Reference Laboratory); and Debbie Marriott (St Vincents Hospital, Sydney) and Michael Jones (Macquarie University, Sydney).

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Correspondence to Elliott Geoffrey Playford.

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On behalf of PSIFIC Study Group.

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Playford, E.G., Lipman, J., Kabir, M. et al. Assessment of clinical risk predictive rules for invasive candidiasis in a prospective multicentre cohort of ICU patients. Intensive Care Med 35, 2141–2145 (2009). https://doi.org/10.1007/s00134-009-1619-9

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  • DOI: https://doi.org/10.1007/s00134-009-1619-9

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