Trial reportIntensive care medicine2014
Candida in the respiratory tract secretions of critically ill patients and the impact of antifungal treatment: a randomized placebo controlled pilot trial (CANTREAT study).
Trial report in Intensive care medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 5 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
37 citing papers in PubMed, 5 syntheses or guidelines pooled it, 60 citations in OpenAlex.
- Pooled it
- Pooled it
- Heterogeneity of surrogate outcome measures used in critical care studies: A systematic review.Clinical trials (London, England) · 2023Pooled it
- Impact of selective digestive decontamination on respiratory tract Candida among patients with suspected ventilator-associated pneumonia. A meta-analysis.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2016Pooled it
- Antifungal agents for preventing fungal infections in non-neutropenic critically ill patients.The Cochrane database of systematic reviews · 2016Pooled it
- No Survival Benefit Associated With Antifungal Therapy for RespiratoryOpen forum infectious diseases · 2026Article
- Visible Photosensitizing Disinfectant Spray for Combating Multidrug-ResistantExploration (Beijing, China) · 2026Article
- Candida in the lung: Fact, fiction, friend or foe?PLoS pathogens · 2026Article
- Co-variation between blood stream infections with Candida species versus Pseudomonas aeruginosa, Staphylococcus aureus, and other isolates among 60 ICU patient cohorts.Medical mycology · 2026Article
- Immune monitoring, immune phenotyping, and precision intervention in severe pneumonia: current evidence and translational challenges.Frontiers in immunology · 2026Review
- Diagnosis and management of invasive candidiasis in critically ill patients: SIAARTI multidisciplinary statement.Journal of anesthesia, analgesia and critical care · 2025Review
- Associations Between Candida andMicroorganisms · 2025Article
- Structural Equation Modelling as a Proof-of-Concept Tool for Mediation Mechanisms Between Topical Antibiotic Prophylaxis and Six Types of Blood Stream Infection Among ICU Patients.Antibiotics (Basel, Switzerland) · 2024Review
- Isolation ofJournal of fungi (Basel, Switzerland) · 2024Article
- Practical Lessons on Antimicrobial Therapy for Critically Ill Patients.Antibiotics (Basel, Switzerland) · 2024Review
- Description of the colonizing mycobiota of endotracheal tubes from patients admitted to two intensive care units in Bogotá, ColombiaBiomedica : revista del Instituto Nacional de Salud · 2023Article
- Staphylococcus aureus hitchhiking from colonization to bacteremia via Candida within ICU infection prevention studies: a proof of concept modelling.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2023Observational
- Candida and the Gram-positive trio: testing the vibe in the ICU patient microbiome using structural equation modelling of literature derived data.Emerging themes in epidemiology · 2022Article
- Structural equation modelling the relationship between anti-fungal prophylaxis and Pseudomonas bacteremia in ICU patients.Intensive care medicine experimental · 2022Article
- Article
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Authors and funding
9 authors at 8 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeCandida spp. are frequently recovered from endotracheal secretions in critically ill patients suspected of having ventilator-associated pneumonia. Observational studies reported an association with worse clinical outcomes but the effect of antifungal therapy in these patients remains unclear. We designed this pilot study to assess the feasibility of a larger trial and to evaluate inflammatory profiles and clinical outcomes in these patients.
methodsWe conducted a double-blind, placebo-controlled, multicenter pilot randomized trial of antifungal therapy in critically ill patients with a clinical suspicion of ventilator-associated pneumonia with positive airway secretion specimens for Candida spp. We also included an observational group without Candida spp. in their airway secretions. We measured recruitment rate, inflammatory and innate immune function profiles over time, and clinical outcomes.
resultsWe recruited 60 patients into the randomized trial and 29 patients into the observational study. Markers of inflammation and all clinical outcomes were comparable between placebo and antifungal treatment group at baseline and over time. At baseline, plasma TNF-α levels were higher in patients with VAP and Candida compared to the observational group (mean ± SD) (21.8 ± 23.1 versus 12.4 ± 9.3 pg/ml, p = 0.02) and these patients had lower innate immune function as evidenced by reduced whole blood ex vivo LPS-induced TNF-α production capacity (854.8 ± 855.2 versus 1,559.4 ± 1,290.6 pg/ml, p = 0.01).
conclusionsThis study does not provide evidence to support a larger trial examining the efficacy of empiric antifungal treatment in patients with a clinical suspicion of ventilator-associated pneumonia and Candida in the endotracheal secretions. The presence of Candida in the lung may be associated with persistent inflammation and immunosuppression.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.