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Shifting Patterns in the Epidemiology of Nosocomial Candida Infections
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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“C albicans has historically been the predominant pathogen in IC with rates of 80% or higher in the 1980s.3,25”
From Fungal Sepsis: Optimizing Antifungal Therapy in the Critical Care Setting (2011) · cites this paper as [25]
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Metadata
- Authors
- Snydman, D. R.
- Affiliations
- Tufts University (US)
- Corresponding author
- Snydman, David R.
- ORCID
- 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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