Monocyte human leukocyte antigen-DR but not β-d-glucan may help early diagnosing invasive Candida infection in critically ill patients
| العنوان: | Monocyte human leukocyte antigen-DR but not β-d-glucan may help early diagnosing invasive Candida infection in critically ill patients |
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| المؤلفون: | Pierre Portales, Samir Jaber, Gerald Chanques, Laurence Lachaud, Clément Le Bihan, Matthieu Conseil, Pablo Lucas Massanet, Nathalie Bourgeois, Boris Jung, Philippe Corne, Thierry Vincent, Jean-François Timsit |
| المساهمون: | Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Maladies infectieuses et vecteurs : écologie, génétique, évolution et contrôle (MIVEGEC), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD [France-Sud]), Institut des Neurosciences de Montpellier (INM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), CIC - CHU Bichat, Institut National de la Santé et de la Recherche Médicale (INSERM), Génétique et évolution des maladies infectieuses (GEMI), Retiveau, Nolwenn, Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS) |
| المصدر: | Annals of Intensive Care Annals of Intensive Care, Vol 11, Iss 1, Pp 1-11 (2021) Annals of Intensive Care, 2021, 11 (1), pp.129. ⟨10.1186/s13613-021-00918-1⟩ Annals of Intensive Care, SpringerOpen, 2021, 11 (1), ⟨10.1186/s13613-021-00918-1⟩ |
| بيانات النشر: | Springer International Publishing, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | medicine.medical_specialty, [SDV]Life Sciences [q-bio], Critical Care and Intensive Care Medicine, Gastroenterology, 03 medical and health sciences, 0302 clinical medicine, Immune system, Intensive care, Internal medicine, Anesthesiology, Septic shock, Medicine, 030212 general & internal medicine, Glucan, chemistry.chemical_classification, 0303 health sciences, mHLA-DR, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, Beta D-glucan, 030306 microbiology, business.industry, RC86-88.9, Monocyte, Research, Hazard ratio, Candidiasis, Medical emergencies. Critical care. Intensive care. First aid, medicine.disease, 3. Good health, [SDV] Life Sciences [q-bio], medicine.anatomical_structure, chemistry, Biomarker (medicine), business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology |
| الوصف: | Background Precision medicine risk stratification is desperately needed to both avoid systemic antifungals treatment delay and over prescription in the critically ill with risk factors. The aim of the present study was to explore the combination of host immunoparalysis biomarker (monocyte human leukocyte antigen-DR expression (mHLA-DR)) and Candida sp wall biomarker β-d-glucan in risk stratifying patients for secondary invasive Candida infection (IC). Methods Prospective observational study. Two intensive care units (ICU). All consecutive non-immunocompromised septic shock patients. Serial blood samples (n = 286) were collected at day 0, 2 and 7 and mHLA-DR and β-d-glucan were then retrospectively assayed after discharge. Secondary invasive Candida sp infection occurrence was then followed at clinicians’ discretion. Results Fifty patients were included, 42 (84%) had a Candida score equal or greater than 3 and 10 patients developed a secondary invasive Candida sp infection. ICU admission mHLA-DR expression and β-d-glucan (BDG) failed to predict secondary invasive Candida sp infection. Time-dependent cause-specific hazard ratio of IC was 6.56 [1.24–34.61] for mHLA-DR 350 pg/mL. Predictive negative value of mHLA-DR > 5000 Ab/c and BDG > 350 pg/mL combination at day 7 was 81% [95% CI 70–92]. Conclusions This study suggests that mHLA-DR may help predicting IC in high-risk patients with septic shock. The added value of BDG and other fungal tests should be regarded according to the host immune function markers. |
| وصف الملف: | application/pdf |
| اللغة: | English |
| تدمد: | 2110-5820 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::855a45ca2281f7eb0f6f28286c2746c5Test http://europepmc.org/articles/PMC8380211Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....855a45ca2281f7eb0f6f28286c2746c5 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 21105820 |
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