1. Multicenter Prospective Study of Biomarkers for Diagnosis of Invasive Candidiasis in Children and Adolescents
- Author
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Brian T Fisher, Craig L K Boge, Rui Xiao, Sydney Shuster, Dawn Chin-Quee, John Allen, Shareef Shaheen, Randall Hayden, Sri Suganda, Theoklis E Zaoutis, Yeh Chung Chang, Dwight E Yin, Anna R Huppler, Lara Danziger-Isakov, William J Muller, Emmanuel Roilides, José Romero, Paul K Sue, David Berman, Rachel L Wattier, Natasha Halasa, Daniel E Dulek, Alice Pong, Gabriela Maron, Pere Soler-Palacin, Susan C Hutto, Blanca E Gonzalez, Christine M Salvatore, Sujatha Rajan, Michael Green, Elizabeth Doby Knackstedt, Sarmistha B Hauger, and William J Steinbach
- Subjects
Microbiology (medical) ,Antigens, Fungal ,Invasive ,Adolescent ,Clinical Trials and Supportive Activities ,Pediatrics ,Medical and Health Sciences ,Microbiology ,Sensitivity and Specificity ,Clinical Research ,parasitic diseases ,Major Article ,Humans ,Candidiasis, Invasive ,Prospective Studies ,Antigens ,Child ,Candida ,screening and diagnosis ,Candidiasis ,biomarkers ,invasive candidiasis ,Biological Sciences ,4.1 Discovery and preclinical testing of markers and technologies ,Detection ,Fungal ,Infectious Diseases ,Biomarkers ,4.2 Evaluation of markers and technologies - Abstract
Background Diagnosis of invasive candidiasis (IC) relies on insensitive cultures; the relative utility of fungal biomarkers in children is unclear. Methods This multinational observational cohort study enrolled patients aged >120 days and Results Five hundred participants were enrolled at 22 centers in 3 countries, and IC was diagnosed in 13 (2.6%). Thirteen additional blood specimens were collected and successfully spiked with Candida species, to achieve a 5.0% event rate. Valid T2Candida, Fungitell, Platelia Candida Ag Plus, and Platelia Candida Ab Plus assay results were available for 438, 467, 473, and 473 specimens, respectively. Operating characteristics for T2Candida were most optimal for detecting IC due to any Candida species, with results as follows: sensitivity, 80.0% (95% confidence interval, 59.3%–93.2%), specificity 97.1% (95.0%–98.5%), positive predictive value, 62.5% (43.7%–78.9%), and negative predictive value, 98.8% (97.2%–99.6%). Only T2Candida and Platelia Candida Ag Plus assays met the threshold for combination testing. Positive result for either yielded the following results: sensitivity, 86.4% (95% confidence interval, 65.1%– 97.1%); specificity, 94.7% (92.0%–96.7%); positive predictive value, 47.5% (31.5%–63.9%); and negative predictive value, 99.2% (97.7%–99.8%). Conclusions T2Candida alone or in combination with Platelia Candida Ag Plus may be beneficial for rapid detection of Candida species in children with concern for IC. Clinical Trials Registration NCT02220790.
- Published
- 2022
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