Unsupervised clustering to classify patients with candidemia in intensive care: algorithmic tautology or the generation of highly anticipated new data? - Takeaways - MDSpire
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Unsupervised Clustering of Intensive Care Patients With Candidemia: Circular Algorithm or Valuable New Insights?

  • By

  • Florian Reizine

  • Renaud Prével

  • Jean-Pierre Gangneux

  • October 15, 2026

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  • 1

    The authors argue that clustering provides quantitative, reproducible candidemia phenotypes and identified enrichment of Candida glabrata in Phenotype 2 and Candida parapsilosis in Phenotype 3.

  • 2

    Phenotypes 1 and 2 had comparably high mortality despite differing clinical profiles characterized by immunosuppression and cirrhosis, respectively.

  • 3

    After SAPS II was removed, Phenotype 1 remained identifiable, with mortality of 70.1% versus 72.9% in the original model.

  • 4

    Without SAPS II, Phenotypes 2 and 3 became less distinct, patients shifted between groups, and Candida glabrata enrichment in the cirrhotic/digestive cluster persisted.

  • 5

    The authors acknowledge the study’s retrospective design and lack of external validation and propose future clustering that separates biological signatures from severity stratification.

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