Failure to Validate a Multivariable Clinical Prediction Model to Identify Pediatric Intensive Care Unit Patients at High Risk for Candidemia

Fisher, Brian T.; Ross, Richard N.; Roilides, Emmanuel; Palazzi, Debra L.; Abzug, Mark J.; Hoffman, Jill A.; Berman, David M.; Prasad, Priya; Localio, A. Russell; Steinbach, William J.; Vogiatzi, Lambrini; Dutta, Ankhi; Zaoutis, Theoklis E.

doi:10.1093/jpids/piv024

Cited by 15 publications

(10 citation statements)

References 10 publications

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“…62 Unfortunately, this clinical prediction rule was not validated in a multicentre setting (5 medical centres in the US and 1 in Greece), where no significant association of candidemia was found with most of the previously identified predictors. 63 Small cohorts, substantial variation in antibiotic exposures in different units, and differences in the frequency of underlying oncologic diseases among critically ill case patients and controls were likely the reasons for this result. 64 Predicting candidemia in critically ill adults has also been problematic.…”

Section: Ris K Fac Tor S For De Velopment Of C Andidemiamentioning

confidence: 99%

Candidemia in children: Epidemiology, prevention and management

Mantadakis

Pana

Zaoutis

2018

Mycoses

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Candidemia is the leading cause of invasive fungal infections in hospitalised children. The highest rates of candidemia have been recorded in neonates and infants <1 year of age. Candidemia is more frequent in neonates and young infants than in adults, and is associated with better clinical outcomes, but higher inpatient costs. Over the last 10 years, a declining trend has been noted in the incidence of paediatric candidemia in the US and elsewhere due to the hospital-wide implementation of central-line insertion and maintenance bundles that emphasise full sterile barrier precautions, chlorhexidine skin preparation during line insertion, meticulous site and tubing care, and daily discussion of catheter necessity. Additional interventions aiming at reducing gut-associated candidemia are required in immunocompromised and critically ill children.

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Section: Ris K Fac Tor S For De Velopment Of C Andidemiamentioning

confidence: 99%

Candidemia in children: Epidemiology, prevention and management

Mantadakis

Pana

Zaoutis

2018

Mycoses

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“…The authors developed a prediction model by combining the aforementioned factors (>10% risk) and observed a predicted probability of candidemia that ranged from 10.7% to 46% [ 73 ]. However, an attempt to validate the prediction model in a multicenter study proved unsuccessful [ 77 ]. A separate predictive IC probability model for PICU patients, the ERICAP scoring system, was developed by Jordan et al [ 5 ].…”

Section: Patients Admitted To a Picumentioning

confidence: 99%

Recognition and Clinical Presentation of Invasive Fungal Disease in Neonates and Children

King

Pana

Lehrnbecher

et al. 2017

Journal of the Pediatric Infectious Diseases Society

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Invasive fungal diseases (IFDs) are devastating opportunistic infections that result in significant morbidity and death in a broad range of pediatric patients, particularly those with a compromised immune system. Recognizing them can be difficult, because nonspecific clinical signs and symptoms or isolated fever are frequently the only presenting features. Therefore, a high index of clinical suspicion is necessary in patients at increased risk of IFD, which requires knowledge of the pediatric patient population at risk, additional predisposing factors within this population, and the clinical signs and symptoms of IFD. With this review, we aim to summarize current knowledge regarding the recognition and clinical presentation of IFD in neonates and children.

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“…To validate this model, a prospective, multi-center case-control study was performed at six free standing pediatric institutions [ 18 ]. The study included 286 patients (96 cases and 190 controls).…”

Section: Introductionmentioning

confidence: 99%

Pediatric Invasive Candidiasis: Epidemiology and Diagnosis in Children

Steinbach

2016

JoF

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Pediatric patients present with differing underlying conditions and cytotoxic therapeutic protocols, so the differing epidemiology of invasive candidiasis in children versus adults is not surprising. Understanding the Candida species epidemiology is critical, as we often begin empiric therapy or therapy before antifungal susceptibilities are known. Reports with newer molecular diagnostic assays for invasive candidiasis are rare and require more study to develop firm pediatric-specific guidance. Antifungal treatment of pediatric candidiasis is reviewed in the context of larger epidemiologic studies and the few trials completed to date.

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Failure to Validate a Multivariable Clinical Prediction Model to Identify Pediatric Intensive Care Unit Patients at High Risk for Candidemia

Cited by 15 publications

References 10 publications

Candidemia in children: Epidemiology, prevention and management

Candidemia in children: Epidemiology, prevention and management

Recognition and Clinical Presentation of Invasive Fungal Disease in Neonates and Children

Pediatric Invasive Candidiasis: Epidemiology and Diagnosis in Children

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