Abstract | BACKGROUND: 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 < 5000 Ab/c and 5.25 [0.47-58.9] for BDG > 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.
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Authors | Boris Jung, Clément Le Bihan, Pierre Portales, Nathalie Bourgeois, Thierry Vincent, Laurence Lachaud, Gerald Chanques, Matthieu Conseil, Philippe Corne, Pablo Massanet, Jean François Timsit, Samir Jaber |
Journal | Annals of intensive care
(Ann Intensive Care)
Vol. 11
Issue 1
Pg. 129
(Aug 21 2021)
ISSN: 2110-5820 [Print] Germany |
PMID | 34417900
(Publication Type: Journal Article)
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Copyright | © 2021. The Author(s). |