Values of different fungal infection risk scoring methods for the early diagnosis of invasive Candida infection / 中国感染控制杂志

ABSTRACT

Objective To compare diagnostic value of four fungal scoring methods in invasive Candida infection,provide evidence for early diagnosis and treatment of invasive Candida infection.Methods High-risk patients with invasive Candida infection in the intensive care unit(ICU) in a hospital from 2011 to 2016 were analyzed retrospectively.According to diagnostic criteria,patients were divided into four groups:non-infection group,suspected infection group,clinically diagnosed group,and confirmed group,patients were conducted multi-diseases risk assessment (MDRA) score,invasive fungal infections risk scoring system (IFIRSS) score,Sevilla score,and Candida score,diagnostic value of four scoring methods for invasive Candida infection were evaluated.Results There were 275 high-risk patients,138 in non-infection group,63 in suspected infection group,and 74 in infection group(clinically diagnosed group:n =64;confirmed group:n =10).The age and length of hospital stay in the infection group were all higher than non-infection group (both P＜0.05).74 strains of Candida were isolated from 74 infected patients,mainly Candida albicans (n =60,81.1％).Positive rates for MDRA score,Candida score,Sevilla score,and IFIRSSscore were 41.5％(n =114),30.2％(n =83),15.3％(n =42),and 8.4％ (n =23) respectively.Of four MDRA scoring methods,MDRA had the higher sensitivity(Se,59％) but lowest specificity(Sp,66％);IFIRSS had higher Sp(91％) but very low Se (9％);Sevilla score had the highest Sp (96％)and higher Se(45％);Candida score had the highest Se(68％) and higher Sp (90％).Conclusion Sevilla score has higher Se and Sp,which can be used in early diagnosis of invasive Candida infection;Candida score has the highest coincidence with clinical diagnostic criteria for invasive Candida infection,both Se and Sp are high,which is of great value for early diagnosis of invasive Candida infection.