title: [Diagnostic methods in candidemia: a systematic review of literature with meta-analysis].
abstract: Candidemia is a disease with high morbidity and mortality especially in critical care patients. Early diagnosis enables early treatment.
  
  
  OBJECTIVE
  To conduct a systematic review of the literature in order to establish the best laboratory tests for the diagnosis of candidemia in critical patients.
  
  
  METHODS
  We conducted a systematic review of available literature in PubMed. Serological studies were subjected to meta-analysis in metadisk-Beta 1.1.1.
  
  
  RESULTS
  4 studies of 1286 reviewed were included. Three were about serological tests and one about molecular testing (RT-PCR). The sensitivity and specificity for RT-PCR, antibody testing and antigen and antibody tests were 87% and 100%, 47.5% and 82.6%, 96% and 81%, respectively. Diagnostic Odds Ratio of antigenemia was 1.51 (95% CI = 0,032-70,964, p = 0.001).
  
  
  CONCLUSIONS
  RT-PCR has better diagnostic performance, measuring antigenemia plus antibodies improves sensitivity, specificity, LR + and LR-- . There is insufficient evidence to support this.
authors: Departamento de Medicina Interna, Universidad Nacional de Colombia, Bogotá, Colombia. jorgecortes@yahoo.com
authors: Jorge Alberto
authors: JA
authors: Cortés
authors: Alejandro
authors: A
authors: Concha M
authors: Luis Eduardo
authors: LE
authors: Cediel T
authors: Juan Sebastián
authors: JS
authors: Castillo
mesh_terms: D000908:Antibodies, Fungal / Q000097:blood; D000946:Antigens, Fungal / Q000097:blood; D002175:Candida / Q000235:genetics / Q000276:immunology; D058387:Candidemia / Q000175:diagnosis*; D016638:Critical Illness; D003428:Cross Infection / Q000175:diagnosis* / Q000382:microbiology; D006801:Humans; D007362:Intensive Care Units; D060888:Real-Time Polymerase Chain Reaction; D012680:Sensitivity and Specificity
chemical_list: D000908:Antibodies, Fungal; D000946:Antigens, Fungal