Table 1 Characteristics of selected studies
From: Risk factors for invasive fungal disease in critically ill adult patients: a systematic review
Study | Study type | Selection criteria | Study design | Number of ICUs | Total patients | Patients with outcomes/cases | Outcome/case definition |
|---|---|---|---|---|---|---|---|
Agvald-Ohman et al., 2008 [28] | Risk factor analysis | Any multidisciplinary ICU patients LOS ≥ 7 days | Prospective cohort | 1 | 59 | 10 | Blood and/or sterile body site culture positive for Candida species |
Blumberg et al., 2001 [29] | Risk factor analysis | SICU patients LOS > 48 hours | Prospective cohort | 6 | 4,276 | 42 | Candida species recovered from culture of blood specimen collected > 48 hours after admission to SICU |
Borzotta & Beardsley, 1999 [34] | Risk factor analysis | Trauma ICU patients Cases selected if LOS > 4 days, age > 16 years and any evidence of fungal infection or treatment Controls matched for sex, mechanism of injury, age and Injury Severity Score Controls selected at 2:1 ratio | Case-control | 1 | 656 | 20 | Blood culture positive for yeast infection Yeast from any sterile area Funguria with signs of sepsis and no bacterial pathogen source if > 105 colonies/ml yeast Candida growth at two sites with fever and WBC count > 12,000/μl and no bacterial isolates within 48 hours |
Chow et al., 2008 [30] | Risk factor analysis | Medical or SICU patients Cases selected if positive blood culture for Candida species after the first 48 hours of admission to unit Controls matched for study hospital, ICU type and admission date Controls selected at 5:1 ratio | Case-control | 2 | 926 | 146 | At least one blood culture positive for Candida species |
Ibà ñez-Nolla et al., 2004 [31] | Risk factor analysis | Any multidisciplinary ICU patients Candida species in culture or on histological examination during ICU stay or postmortem Neutrophil count ≥ 500/mm3 | Prospective cohort | 1 | 145 | 120 | Multifocal candidiasis: simultaneous isolation of Candida species in two or more of the following locations: respiratory, digestive or urinary tract or other locations or Disseminated candidiasis, yeasts in fluids from sterile sites or histological samples from deep organs or diagnosis of endophthalmitis or candidaemia with negative catheter tip cultures Also, use of EORTC/MSG guidelines |
Jordà -Marcos et al., 2007 [26]a | Risk factor analysis | Any multidisciplinary ICU patients Age > 18 years LOS ≥ 7 days | Prospective cohort | 73 | 1,765 | 63 | At least one blood culture positive for Candida species |
León et al., 2006 [27]a | Development of risk prediction model | Multidisciplinary ICU patients Age > 18 years LOS ≥ 7 days Only patients with fungal colonisation included in risk factor analysis/model development | Prospective cohort | 73 | 1,699 | 97 | Candidaemia Candidal endophthalmitis in a patient with clinical sepsis Candida species from sterile sites Histologically documented candidiasis |
Michalopoulos et al., 2003 [36] | Risk factor analysis | Cardiothoracic ICU patients Cases selected if at least one blood culture positive for Candida species detected Controls matched for admission date, gender, BMI, sedatives, CPB technique and cardioplegia type Controls selected at 4:1 ratio | Case-control | 1 | 150 | 30 | At least one blood culture positive for Candida species |
McKinnon et al., 2001 [32] | Risk factor analysis | SICU patients LOS ≥ 5 days Age > 18 years | Prospective cohort | 3 | 301 | 27 | Colonisation of two or more sites or candidaemia |
Ostrosky-Zeichner et al., 2007 [37] | Development of clinical decision rule | Multidisciplinary ICU patients Age ≥ 19 years LOS ≥ 4 days No evidence of invasive candidiasis or systemic antifungal use in week prior to ICU admission through first 3 days of admission | Retrospective cohort | 12 | 2,890 | 88 | EORTC/MSG criteria |
Paphitou et al., 2005 [35] | Development of clinical decision rule | SICU patients LOS ≥ 4 days | Retrospective cohort | 1 | 327 | 36 | Based on proven, probable or possible cases Criteria modelled on EORTC/MSG criteria |
Piarroux et al., 2004 [38] | Evaluation of clinical decision rule | SICU patients LOS ≥ 5 days Excluded liver transplants | Prospective and retrospective cohorts | 1 | 933 | 50 | EORTC/MSG criteria |
Pittet et al., 1994 [33] | Risk factor analysis and development of clinical decision rule | SICU/neonatal ICU patients Candida colonisation in three or more samples on two consecutive days | Prospective cohort | 2 | 29 | 11 | Candidaemia or One blood culture with one histologically documented invasive candidiasis or Ophthalmic examination consistent with candidal endophthalmitis or At least two blood cultures taken at different times or One peripheral blood culture and one central line blood culture showing identical Candida species or Severe nonbloodstream Candida species infection Candida species in normally sterile site and at least one of the following: Fever or hypothermia Unexplained, prolonged hypotension No response to adequate antibiotic treatment for a suspected bacterial infection |