Early diagnosis of invasive candidiasis in intensive care: evaluation of diagnostic biomarkers

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F61988987%3A17110%2F25%3AA2603BLX" target="_blank" >RIV/61988987:17110/25:A2603BLX - isvavai.cz</a>

Výsledek na webu

<a href="https://linkinghub.elsevier.com/retrieve/pii/S2950590925000277" target="_blank" >https://linkinghub.elsevier.com/retrieve/pii/S2950590925000277</a>

DOI - Digital Object Identifier

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Jazyk výsledku

angličtina

Název v původním jazyce

Early diagnosis of invasive candidiasis in intensive care: evaluation of diagnostic biomarkers

Popis výsledku v původním jazyce

BackgroundInvasive candidiasis (IC) remains a major challenge in critically ill patients, requiring rapid and accurate diagnosis to improve patient outcomes. Traditional blood culture methods often fail to detect Candida spp. in the early stages of infection. This study aimed to assess the utility of modern diagnostic biomarkers: T2Candida®, (1,3)-β-D-glucan (BDG), Presepsin (PSEP), and Pentraxin 3 (Ptx3) in differentiating fungal from bacterial infections and improving early IC detection in septic patients.MethodsThis prospective clinical study was conducted at University Hospital Ostrava from May to December 2024. Ten intensive care unit (ICU) patients were enrolled and monitored daily using a panel of biomarkers (BDG, PSEP, Ptx3) in conjunction with molecular (T2Candida®) and microbiological (blood culture) diagnostic methods. Serum BDG was measured using Fungitell®, PSEP was analyzed with Pathfast®, and Ptx3 was assessed via ELISA on the ThunderBolt Analyzer. All biomarker results were correlated with clinical findings, including patient colonization status, intra-abdominal candidiasis (IAC), and bacterial co-infections.ResultsSerum BDG levels exceeding 200 pg/mL and PSEP levels above 700 pg/mL were indicative of probable IC. Ptx3 demonstrated potential as an additional diagnostic marker, with elevated levels correlating with suspected fungal infections. The T2Candida® assay showed limited sensitivity for IAC, detecting Candida spp. in only a small subset of cases. Despite the application of molecular diagnostics, direct blood culture positivity for Candida spp. was rare, aligning with previous findings that candidemia often remains undetected in IAC patients. For detailed biomarker profiles, refer to Biomarker Profiles in Invasive Candidiasis Diagnosis.ConclusionsThe combination of BDG, PSEP, and Ptx3 shows promise for early IC detection, particularly in differentiating fungal from bacterial sepsis. The findings highlight the limitations of T2Candida® in IAC cases and suggest the need for further validation in a larger patient cohort. These preliminary results represent the first phase of an ongoing prospective study, which will continue in 2025 to expand the patient cohort and refine diagnostic algorithms. Future research should focus on optimizing the use of multiple biomarkers to enhance early IC diagnosis and improve antifungal treatment strategies.

Název v anglickém jazyce

Early diagnosis of invasive candidiasis in intensive care: evaluation of diagnostic biomarkers

Popis výsledku anglicky

BackgroundInvasive candidiasis (IC) remains a major challenge in critically ill patients, requiring rapid and accurate diagnosis to improve patient outcomes. Traditional blood culture methods often fail to detect Candida spp. in the early stages of infection. This study aimed to assess the utility of modern diagnostic biomarkers: T2Candida®, (1,3)-β-D-glucan (BDG), Presepsin (PSEP), and Pentraxin 3 (Ptx3) in differentiating fungal from bacterial infections and improving early IC detection in septic patients.MethodsThis prospective clinical study was conducted at University Hospital Ostrava from May to December 2024. Ten intensive care unit (ICU) patients were enrolled and monitored daily using a panel of biomarkers (BDG, PSEP, Ptx3) in conjunction with molecular (T2Candida®) and microbiological (blood culture) diagnostic methods. Serum BDG was measured using Fungitell®, PSEP was analyzed with Pathfast®, and Ptx3 was assessed via ELISA on the ThunderBolt Analyzer. All biomarker results were correlated with clinical findings, including patient colonization status, intra-abdominal candidiasis (IAC), and bacterial co-infections.ResultsSerum BDG levels exceeding 200 pg/mL and PSEP levels above 700 pg/mL were indicative of probable IC. Ptx3 demonstrated potential as an additional diagnostic marker, with elevated levels correlating with suspected fungal infections. The T2Candida® assay showed limited sensitivity for IAC, detecting Candida spp. in only a small subset of cases. Despite the application of molecular diagnostics, direct blood culture positivity for Candida spp. was rare, aligning with previous findings that candidemia often remains undetected in IAC patients. For detailed biomarker profiles, refer to Biomarker Profiles in Invasive Candidiasis Diagnosis.ConclusionsThe combination of BDG, PSEP, and Ptx3 shows promise for early IC detection, particularly in differentiating fungal from bacterial sepsis. The findings highlight the limitations of T2Candida® in IAC cases and suggest the need for further validation in a larger patient cohort. These preliminary results represent the first phase of an ongoing prospective study, which will continue in 2025 to expand the patient cohort and refine diagnostic algorithms. Future research should focus on optimizing the use of multiple biomarkers to enhance early IC diagnosis and improve antifungal treatment strategies.

Druh

D - Stať ve sborníku

CEP obor

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OECD FORD obor

30230 - Other clinical medicine subjects

Projekt

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Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2025

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název statě ve sborníku

ESCMID Global Abstract Book 2025

ISBN

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ISSN

2950-5909

e-ISSN

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Počet stran výsledku

1

Strana od-do

4932-4932

Název nakladatele

European Society of Clinical Microbiology and Infectious Diseases

Místo vydání

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Místo konání akce

Vienna

Datum konání akce

11. 4. 2025

Typ akce podle státní příslušnosti

WRD - Celosvětová akce

Kód UT WoS článku

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