TABLE 2.

Prevalence of candidemia in different populations and anticipated PPVs and NPVs of nonculture tests^a

^aReferences for prevalence of candidemia in various patient populations are summarized in reference 21. The sensitivity and specificity of each assay for candidemia are estimated from meta-analyses of combined mannan/antimannan, BDG, and PCR assays and the T2Candida DIRECT and DIRECT2 studies, as cited in the text. Data for CAGTA are more limited, but performance for the diagnosis of candidemia complicated by deep-seated candidiasis appears to be comparable to that of mannan/antimannan and BDG. PPV, positive predictive value; NPV, negative predictive value. Shading and bold PPV and NPV values signify patients for whom nonculture testing may have greatest clinical utility, assuming that antifungal treatment is justified at a threshold likelihood of invasive candidiasis of ≥∼15 to 30%. For the patients indicated, a positive result is anticipated to move the likelihood of candidemia from below the threshold to above the threshold. At the same time, negative tests make candidemia extremely unlikely (≤3% probability). The precise borders of the box may vary somewhat, depending on where within the 15 to 30% range the threshold value is set. See further discussion in “Incorporating Nonculture Tests into Patient Care” in the text.

^b Sensitivity/specificity, 80%/80%.

^c Sensitivity/specificity, 90%/90%.

^d Sensitivity/specificity, 90%/98%.