Cited by 142Antifungal resistance and susceptibilityOcular Infections and TreatmentsNosocomial Infections in ICU

Shifting patterns in the epidemiology of nosocomial Candida infections

Snydman, David R.·2003·Chest

Abstract

The incidence of candidemia--a common and potentially fatal nosocomial infection--has risen dramatically, and this increase has been accompanied by a shift in the infecting pathogen away from Candida albicans to treatment-resistant non-albicans species. Prophylactic azole antifungals, such as fluconazole, may play an important role not only in the management of candidemia but also in the proliferation of hard-to-treat Candida species. In a variety of acute nosocomial settings, IV fluconazole, 400 mg/d, has reduced Candida colonization and infection. A growing body of evidence supports the still controversial contention that the increasing use of azole antifungals is at least partially responsible for the proliferation of treatment-resistant, non-albicans isolates, especially Candida glabrata. Thus, selecting the most appropriate candidates for prophylactic antifungal intervention--ie, those with the highest risk for candidemia--may be indispensable, not only in preventing candidemia, but also in reducing antifungal overuse, which may contribute to the emergence of treatment-resistant Candida isolates.

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Crossref · 10.1378/chest.123.5_suppl.500s

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  • Candida albicans has historically been the predominant pathogen in invasive candidiasis, with rates of 80% or higher in the 1980s.

    “C albicans has historically been the predominant pathogen in IC with rates of 80% or higher in the 1980s.3,25”

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Authors
Snydman, D. R.
Affiliations
Tufts University (US)
Corresponding author
Snydman, David R.
Venue
Chest
Publisher
Elsevier BV
Published
2003-05
Volume
123
Issue
5
Pages
500S-503S
ISSN
0012-3692 (ISSN-L)
OpenAlex
W2095153363
Cited by
142
References
16
Citations by year
2026: 1 · 2024: 3 · 2022: 5 · 2021: 3 · 2020: 5 · 2019: 4 · 2018: 4 · 2017: 10 · 2016: 6 · 2015: 6 · 2014: 4 · 2013: 9 · 2012: 4
FWCI
3.69
Type
journal article
Language
en
Open access
closed
Locations
  • CHEST Journal (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
  • Health Sciences › Medicine › Ophthalmology › Ocular Infections and Treatments
  • Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Nosocomial Infections in ICU
Keywords
candidemia, nosocomial candidiasis, Candida albicans, non-albicans Candida, Candida glabrata, antifungal resistance, fluconazole, Candida colonization
MeSH terms
Antifungal Agents, Candidiasis, Cross Infection, Humans, Sensitivity and Specificity, Fluconazole, Incidence, Candida glabrata

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