This is a prospective study aimed at testing a strategy of early initiation of an antifungal
agent to patients admitted to intensive care units (ICUs) at risk for invasive candidiasis.
Score system have been developed to identify groups at very high risk for the development of
candidemia/invasive candidiasis in the ICU. These scoring system have used clinical
information with or without data on Candida colonization, and have shown reasonable
correlation with candidemia/invasive candidiasis. More recently, a biomarker - detection of
1,3-beta-D-glucan in the serum - has been tested in the early diagnosis of candidiasis. The
incorporation of biomarkers such as beta-D-glucan could help clinicians to select a group at
higher risk for candidemia, and despite the fact that these tests may give false-positive
results, their negative predictive value could be of great help.
Therefore, the objectives of this study are:
1. To assess the frequency of positive biomarkers in ICU patients at high risk to develop
invasive candidiasis/candidemia;
2. To test the strategy of early discontinuation of antifungal therapy based on repeatedly
negative blood cultures and 1,3 beta-D-glucan in the serum.