{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T22:52:29Z","timestamp":1789080749883,"version":"build-2803163510"},"reference-count":43,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2021,12,6]],"date-time":"2021-12-06T00:00:00Z","timestamp":1638748800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JoF"],"abstract":"<jats:p>Non-culture-based biomarkers may improve diagnosis and antifungal treatment (AFT) of invasive candidiasis (IC). We evaluated an antifungal stewardship programme (AFSP) in a prospective intensive care unit (ICU) study, which included T2Candida and Candida mannan antigen (MAg) screening of patients with sepsis and a high risk of IC. Patients with non-neutropenic sepsis and a high risk of IC from two large tertiary ICUs were prospectively included, during a one-year period. IC was classified as proven, likely, possible or unlikely. The AFSP, diagnostic values of T2Candida and MAg, and the consumption of antifungals were evaluated. An amount of 219 patients with 504 T2Candida\/MAg samples were included. IC was classified as proven in 29 (13.2%), likely in 7 (3.2%) and possible in 10 (5.5%) patients. Sensitivity\/specificity\/PPV\/NPV values, comparing proven\/likely versus unlikely IC, were 47%\/100%\/94%\/90% for BC alone, 50%\/97%\/75%\/90% for T2Candida alone, and 39%\/96%\/67%\/88% for MAg alone. For the combination of T2Candida\/MAg taken \u22643 days after AFT initiation, sensitivity\/specificity\/PPV\/NPV was 70%\/90%\/63%\/93%. T2Candida\/MAg contributed to early (&lt;3 days) AFT initiation in 13%, early AFT discontinuation in 25% and abstaining from AFT in 24% of patients. No reduction in overall use of AFT during the study period compared with the previous year was observed. An AFSP based on T2Candida and MAg screening contributed to a reduction of unnecessary treatment, but not overall AFT use. The diagnostic performance of T2Candida was lower than previously reported, but increased if T2Candida was combined with MAg.<\/jats:p>","DOI":"10.3390\/jof7121044","type":"journal-article","created":{"date-parts":[[2021,12,6]],"date-time":"2021-12-06T22:18:42Z","timestamp":1638829122000},"page":"1044","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Intensive Care Antifungal Stewardship Programme Based on T2Candida PCR and Candida Mannan Antigen: A Prospective Study"],"prefix":"10.3390","volume":"7","author":[{"given":"Jannik","family":"Helweg-Larsen","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, Rigshospitalet, 2100 Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morten","family":"Steensen","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Rigshospitalet, 2100 Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Finn","family":"M\u00f8ller Pedersen","sequence":"additional","affiliation":[{"name":"Department of Thoracic Anesthesiology, Rigshospitalet, 2100 Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pia","family":"Bredahl Jensen","sequence":"additional","affiliation":[{"name":"Department of Thoracic Anesthesiology, Rigshospitalet, 2100 Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9740-1246","authenticated-orcid":false,"given":"Michael","family":"Perch","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Section for Lung Transplantation, Rigshospitalet, 2100 Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirsten","family":"M\u00f8ller","sequence":"additional","affiliation":[{"name":"Department of Neuro Anesthesiology, Rigshospitalet, 2100 Copenhagen, Denmark"},{"name":"Department of Clinical Medicine, University of Copenhagen, 2100 Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birthe","family":"Riis Olesen","sequence":"additional","affiliation":[{"name":"Department for Economy, Rigshospitalet, 2100 Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathias","family":"S\u00f8derlund","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Rigshospitalet, 2100 Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4747-0144","authenticated-orcid":false,"given":"Maiken","family":"Cavling Arendrup","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, University of Copenhagen, 2100 Copenhagen, Denmark"},{"name":"Unit of Mycology, Statens Serum Institut, 2300 Copenhagen, Denmark"},{"name":"Department of Clinical Microbiology, Rigshospitalet, 2100 Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,12,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"18026","DOI":"10.1038\/nrdp.2018.26","article-title":"Invasive candidiasis","volume":"4","author":"Pappas","year":"2018","journal-title":"Nat. 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