• Yi Xin Liew, Jocelyn Teo, Irene Ai-Ling Too, Cecilia Cheng-Lai Ngan, Ai Ling Tan, Maciej Piotr Chlebicki, Andrea Lay-Hoon Kwa, and Winnie Lee.
• Department of Pharmacy, Singapore General Hospital, Block 8 Level 2, Outram Road, Singapore, 169608, Singapore. liew.yi.xin@sgh.com.sg.
• Bmc Infect Dis. 2015 Jan 1;15:256.

BackgroundColonization of patients occurs before development into invasive candidiasis. There is a need to determine the incidences of Candida colonization and infection in SICU patients, and evaluate the usefulness of beta-D-glucan (BDG) assay in diagnosing invasive candidiasis when patients are colonized.MethodsClinical data and fungal surveillance cultures in 28 patients were recorded from November 2010, and January to February 2011. Susceptibilities of Candida isolates to fluconazole, voriconazole, amphotericin B, micafungin, caspofungin and anidulafungin were tested via Etest. The utilities of BDG, Candida score and colonization index for candidiasis diagnosis were compared via ROC.Results30 BDG assays were performed in 28 patients. Four assay cases had concurrent colonization and infection; 23 had concurrent colonization and no infection; three had no concurrent colonization and infection. Of 136 surveillance swabs, 52 (38.24 %) were positive for Candida spp, with C. albicans being the commonest. Azole resistance was detected in C. albicans (7 %). C. glabrata and C. tropicalis were, respectively, 100 and 7 % SDD to fluconazole. All 3 tests showed high sensitivity of 75-100 % but poor specificity ranging 15.38-38.46 %. BDG performed the best (AUC of 0.89).ConclusionsDespite that positive BDG is common in surgical patients with Candida spp colonization, BDG performed the best when compared to CI and CS.

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