Evidence map›Paper›PMID 37589394›Full record

ArticleJournal of the Pediatric Infectious Diseases Society2023

Adjunctive Diagnostic Studies Completed Following Detection of Candidemia in Children: Secondary Analysis of Observed Practice From a Multicenter Cohort Study Conducted by the Pediatric Fungal Network.

Rachel L Wattier, Robert F T Bucayu, Craig L K Boge, Rachael K Ross, Inci Yildirim, Theoklis E Zaoutis, Debra L Palazzi, Surabhi B Vora, Elio Castagnola, Martha Avilés-Robles and 39 more

Open access · bronzeAbstract readMulticenter Study
In one paragraph

Article in Journal of the Pediatric Infectious Diseases Society, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.0field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 5 citations in OpenAlex.

  1. Persistent Non-Journal of fungi (Basel, Switzerland) · 2026
    Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

49 authors at 20 institutions in 12 countries.

Rachel L WattierDepartment of Pediatrics, University of California San Francisco, San Francisco, California, USA.
Robert F T BucayuDepartment of Pediatrics, University of California San Francisco, San Francisco, California, USA.
Craig L K BogeDepartment of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Rachael K RossDepartment of Epidemiology, University of North Carolina Chapel Hill, Chapel Hill, North Carolina, USA.
Inci YildirimDepartment of Pediatrics, Yale University School of Medicine, Connecticut, USA.
Theoklis E ZaoutisDepartment of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Debra L PalazziDepartment of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, USA.
Surabhi B VoraDepartment of Pediatrics, University of Washington, Division of Infectious Diseases, Seattle Children's Hospital, Seattle, Washington, USA.
Elio CastagnolaDepartment of Pediatrics, IRCCS Istituto Giannina Gaslini, Genoa, Italy.
Martha Avilés-RoblesDepartment of Infectious Diseases, Hospital Infantil de México Federico Gómez, Mexico City, Mexico.
Lara Danziger-IsakovDepartment of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio, USA.
Alison C TribbleDivision of Infectious Diseases, Department of Pediatrics, University of Michigan and C.S. Mott Children's Hospital, Ann Arbor, Michigan, USA.
Tanvi S SharmaDivision of Infectious Diseases, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Antonio C ArrietaDepartment of Infectious Diseases, Children's Hospital of Orange County, Orange, California, USA.
Gabriela MaronDepartment of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.
David M BermanDivision of Pediatric Infectious Diseases, Johns Hopkins All Children's Hospital, St. Petersburg, Florida, USA.
Dwight E YinDepartment of Pediatrics, Children's Mercy and University of Missouri-Kansas City School of Medicine, Kansas City, Missouri, USA.ORCID 0000-0002-8599-1004
Lillian SungDivision of Haematology/Oncology, The Hospital for Sick Children, Toronto, Canada.
Michael GreenDepartment of Pediatrics, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania, USA.
Emmanuel RoilidesInfectious Diseases Unit, 3rd Department of Pediatrics, Aristotle University and Hippokration Hospital, Thessaloniki, Greece.ORCID 0000-0002-0202-364X
Kiran BelaniPediatric Infectious Diseases, Children's Minnesota, Minneapolis, Minnesota, USA.
José RomeroNational Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Pere Soler-PalacinPediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain.ORCID 0000-0002-0346-5570
Eduardo López-MedinaCentro de Estudios en Infectología Pediátrica, Clínica Imbanaco Grupo Quirónsalud and Universidad del Valle, Cali, Colombia.ORCID 0000-0003-3066-5938
Dawn NoltDepartment of Pediatrics, Oregon Health and Science University and Doernbecher Children's Hospital, Portland, Oregon, USA.
Ibrahim Zaid Bin HussainPediatric Infectious Diseases, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
William J MullerDepartment of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago and Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Sarmistha B HaugerDepartment of Pediatrics, University of Texas at Austin and Dell Children's Medical Center, Austin, Texas, USA.
Natasha HalasaDepartment of Pediatrics, Vanderbilt University Medical Center and Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee, USA.
Daniel DulekDepartment of Pediatrics, Vanderbilt University Medical Center and Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee, USA.
Alice PongDepartment of Pediatrics, University of California San Diego and Rady Children's Hospital San Diego, San Diego, California, USA.
Blanca E GonzalezCenter for Pediatric Infectious Diseases, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Mark J AbzugDepartment of Pediatrics, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado, USA.
Fabianne CarlesseInstituto de Oncologia Pediatrica-IOP/GRAACC-UNIFESP, São Paulo, Brazil.
Anna R HupplerDepartment of Pediatrics, Medical College of Wisconsin and Children's Wisconsin, Milwaukee, Wisconsin, USA.
Sujatha RajanDivision of Pediatric Infectious Diseases, Cohen Children's Medical Center, New Hyde Park, New York, USA.
Catherine AftandilianDepartment of Pediatrics, Stanford University School of Medicine, Palo Alto, California, USA.
Monica I ArduraDivision of Infectious Diseases and Host Defense Program, Department of Pediatrics, Nationwide Children's Hospital and The Ohio State University, Columbus, Ohio, USA.ORCID 0000-0002-2853-2581
Arunaloke ChakrabartiDoodhadhar Burfani Hospital and Research Institute, Haridwar, India.ORCID 0000-0003-1555-3807
Benjamin HanischPediatric Infectious Diseases, Children's National Health System, Washington, District of Columbia, USA.ORCID 0000-0003-3387-9093
Christine M SalvatoreDivision of Pediatric Infectious Diseases, Weill Cornell Medicine and Komansky Children's Hospital, New York, New York, USA.ORCID 0000-0002-2087-1044
Lena KlingsporDepartment of Laboratory Medicine, Karolinska Institute, Stockholm, Sweden.
Elizabeth D KnackstedtDepartment of Pediatrics, University of Utah, Salt Lake City, Utah, USA.
Irja LutsarDepartment of Microbiology, University of Tartu, Tartu, Estonia.
Maria E SantolayaHospital Dr. Luis Calvo Mackenna, Facultad de Medicina, Universidad de Chile, Santiago, Chile.
Sydney ShusterDepartment of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Sarah K JohnsonDepartment of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
William J SteinbachDepartment of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
Brian T FisherDepartment of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.ORCID 0000-0002-8224-4281
Children's Hospital of Philadelphia · USMonroe Carell Jr. Children's Hospital · USUniversity of Arkansas for Medical Sciences · USUniversity of California, San Francisco · USBaylor College of Medicine · USBoston Children's Hospital · USCenters for Disease Control and Prevention · USChildren's Hospital Colorado · USChildren's Hospital of Orange County · USChildren's Hospital of Pittsburgh · USChildren's Hospital of Wisconsin · USChildren's Minnesota · USChildren's National · USCincinnati Children's Hospital Medical Center · USCleveland Clinic · USCohen Children's Medical Center · USCornell University · USDell Children's Medical Center of Central Texas · USHippocration General Hospital · GRHospital for Sick Children · CA

Funding

Yale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9M
Multi-center studies to improve diagnosis and treatment of pediatric candidiasisR01AI103315 · NIAID · CHILDREN'S HOSP OF PHILADELPHIA · PI STEINBACH, WILLIAM J, ZAOUTIS, THEOKLIS · 2013 to 2017
$2.9M
NCATS NIH HHS UL1 TR001863NIAID NIH HHS R01 AI103315
6 · The paper itself

Abstract

backgroundAdjunctive diagnostic studies (aDS) are recommended to identify occult dissemination in patients with candidemia. Patterns of evaluation with aDS across pediatric settings are unknown.

methodsCandidemia episodes were included in a secondary analysis of a multicenter comparative effectiveness study that prospectively enrolled participants age 120 days to 17 years with invasive candidiasis (predominantly candidemia) from 2014 to 2017. Ophthalmologic examination (OE), abdominal imaging (AbdImg), echocardiogram, neuroimaging, and lumbar puncture (LP) were performed per clinician discretion. Adjunctive diagnostic studies performance and positive results were determined per episode, within 30 days from candidemia onset. Associations of aDS performance with episode characteristics were evaluated via mixed-effects logistic regression.

resultsIn 662 pediatric candidemia episodes, 490 (74%) underwent AbdImg, 450 (68%) OE, 426 (64%) echocardiogram, 160 (24%) neuroimaging, and 76 (11%) LP; performance of each aDS per episode varied across sites up to 16-fold. Longer durations of candidemia were associated with undergoing OE, AbdImg, and echocardiogram. Immunocompromised status (58% of episodes) was associated with undergoing AbdImg (adjusted odds ratio [aOR] 2.38; 95% confidence intervals [95% CI] 1.51-3.74). Intensive care at candidemia onset (30% of episodes) was associated with undergoing echocardiogram (aOR 2.42; 95% CI 1.51-3.88). Among evaluated episodes, positive OE was reported in 15 (3%), AbdImg in 30 (6%), echocardiogram in 14 (3%), neuroimaging in 9 (6%), and LP in 3 (4%).

conclusionsOur findings show heterogeneity in practice, with some clinicians performing aDS selectively, potentially influenced by clinical factors. The low frequency of positive results suggests that targeted application of aDS is warranted.

Indexed as

CandidemiaCandidiasis, InvasiveAged, 80 and overAntifungal AgentsChildCohort StudiesHumansLogistic ModelsRisk FactorsAntifungal Agentscandidemiaendocarditisendophthalmitisinvasive candidiasispediatrics

Identifiers

PMID37589394
PMCPMC10533205
OpenAlexW4385898020

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.