Combination of serum and peritoneal 1.3-beta-d-glucan can rule out intra-abdominal candidiasis in surgical critically ill patients: a multicenter prospective study
Authors' conclusion
In critically ill patients with intra-abdominal infection requiring surgery, the IAC prevalence was 44%. Combining low sBDG and pBDG with a low peritonitis score effectively excluded IAC and could limit unnecessary antifungal agent exposure.
Study context
- Population
- Consecutive critically ill patients undergoing abdominal surgery for abdominal sepsis, France
- Participants
- 199 patients
- Exposure
- Intra-abdominal candidiasis (IAC) vs non-IAC patients
- Outcome
- IAC prevalence
Methodological detailsmulticentre, noninterventional, consecutive patients
- Multicentre
- Noninterventional
- Consecutive patients
Main finding
As reported in the abstract
IAC
44%
87 events
Observational data: associations, not effects.
Secondary outcomes
Peritoneal BDG (pBDG, WT)
P = 0.0021
Serum BDG with WT (n = 42) · day 1
P = 0.012
Serum BDG with FA (n = 140) · day 1
P = 0.009
- Peritoneal BDG (pBDG, WT) — NPV for IAC at pBDG threshold 45 pg/ml
- 82.3%
Nosocomial origin and IAC (multivariate analysis)
- Nosocomial origin associated with more IAC cases
- P = 0.0399
Combined peritonitis score < 3, sBDG < 3.3 pg/ml (WT) and pBDG < 45 pg/ml (WT)
- NPV for IAC
- 100%
Original publication
Combination of serum and peritoneal 1.3-beta-d-glucan can rule out intra-abdominal candidiasis in surgical critically ill patients: a multicenter prospective study. Crit Care. Published 30 November 2023. doi:10.
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