Invasive candidiasis in the intensive care unit

Ostrosky-Zeichner, Luis; Pappas, Peter G.

doi:10.1097/01.ccm.0000201897.78123.44

Cited by 247Antifungal resistance and susceptibilityNosocomial Infections in ICUOcular Infections and Treatments

Invasive candidiasis in the intensive care unit

Ostrosky-Zeichner, Luis, Pappas, Peter G.·2006·Critical Care Medicine

DOI 10.1097/01.ccm.0000201897.78123.44

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Abstract

OBJECTIVE: To review epidemiologic trends, advances in diagnosis and susceptibility testing, therapeutic options and guidelines, and management strategies for invasive candidiasis as relevant to the intensive care unit physician. DATA SOURCES, STUDY SELECTION, DATA EXTRACTION, DATA SYNTHESIS: Nonstructured review of peer-reviewed original articles, review articles, abstracts, guidelines, and consensus statements appearing in Medline, major scientific journals, and conference proceedings. CONCLUSIONS: Invasive candidiasis is a problem associated with substantial morbidity and mortality that is highly prevalent in the intensive care unit setting. Recent epidemiologic studies have shown a trend toward increasing numbers of infections and a shift toward infections caused by non-albicans Candida species. Guidelines for the management of these diseases have been published and recommend amphotericin B, fluconazole, or caspofungin as the primary therapeutic option. The choice of agent should depend on local epidemiology and patient factors. The role of newer antifungal agents for this population, such as the new azoles and echinocandins, remains to be determined. Priority areas of research include diagnostics, risk identification, and management strategy assessment such as prophylactic, preemptive, and empirical therapy.

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Procalcitonin is undetectable in healthy states, but rises rapidly in response to pro-inflammatory stimuli, especially bacterial infections.
“Procalcitonin is undetectable in healthy states, but rises rapidly in response to pro-inflammatory stimuli, especially bacterial infections (127).”
From Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. (2021) · cites this paper as [127]
Invasive candidiasis lacks specific and objective clinical findings.
“Unfortunately, IC lacks specific and objective clinical findings.3,[50][51][52][53]”
From Fungal Sepsis: Optimizing Antifungal Therapy in the Critical Care Setting (2011) · cites this paper as [51]
Variables associated with invasive candidiasis include high APACHE II score, exposure to broad-spectrum antibiotics, cancer chemotherapy, mucosal colonization by Candida spp, pancreatitis, indwelling vascular catheters (especially central venous catheter), total parenteral nutrition, neutropenia, immune suppression therapy, prior surgery (especially gastrointestinal surgery), renal failure or haem
“Variables that have been associated with IC include high APACHE II score, exposure to broad spectrum antibiotics, cancer chemotherapy, evidence of mucosal colonization by Candida spp, pancreatitis, indwelling vascular catheters (especially central venous catheter [CVC]), administration of total parenteral nutrition, neutropenia, immune suppression therapy, prior surgery (especially gastro”
From Fungal Sepsis: Optimizing Antifungal Therapy in the Critical Care Setting (2011) · cites this paper as [51]

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Authors: Ostrosky-Zeichner, L., & Pappas, P. G.
Affiliations: University of Alabama at Birmingham (US)
ORCID: Pappas, Peter G.
Venue: Critical Care Medicine
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2006-03
Volume: 34
Issue: 3
Pages: 857-863
ISSN: 0090-3493 (ISSN-L)
DOI: 10.1097/01.ccm.0000201897.78123.44
OpenAlex: W2019847904
Semantic Scholar: ebdade43e97f566b3a963c1576baaaae032151ab
Cited by: 247
References: 77
Citations by year: 2025: 7 · 2024: 2 · 2023: 4 · 2022: 4 · 2021: 15 · 2020: 6 · 2019: 12 · 2018: 9 · 2017: 11 · 2016: 14 · 2015: 8 · 2014: 14 · 2013: 11 · 2012: 16
FWCI: 3.22
Type: journal article
Language: en
Open access: closed
Locations: Critical Care Medicine (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Nosocomial Infections in ICU
Health Sciences › Medicine › Ophthalmology › Ocular Infections and Treatments
Keywords: invasive candidiasis, intensive care unit, non-albicans Candida, antifungal susceptibility testing, amphotericin B, fluconazole, caspofungin, echinocandins, azoles, antifungal prophylaxis, empirical antifungal therapy, candidemia
MeSH terms: Antifungal Agents, Candidiasis, Drug Resistance, Microbial, Humans, Intensive Care Units, Risk Factors, Practice Guidelines as Topic

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Invasive candidiasis in the intensive care unit

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