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Objective:

To obtain a score for deciding early antifungal treatment when candidal infection is suspected in nonneutropenic critically ill patients.

Design:

Analysis of data collected from the database of the EPCAN project, an ongoing prospective, cohort, observational, multicenter surveillance study of fungal infection and colonization in intensive care unit (ICU) patients.

Setting:

Seventy-three medical-surgical ICUs of 70 teaching hospitals in Spain.

Patients:

A total of 1,699 ICU patients aged 18 yrs and older admitted for at least 7 days between May 1998 and January 1999 were studied.

Interventions:

Surveillance cultures of urine, tracheal, and gastric samples were obtained weekly. Patients were grouped as follows: neither colonized nor infected (n= 719), unifocal or multifocal Candida colonization (n= 883), and proven candidal infection (n= 97). The odds ratio (OR) for each risk factor associated with colonization vs …