Epidemiology, diagnosis and treatment of systemic Candida infection in surgical patients under intensive care

Vincent, J. L.; Anaissie, E.; Bruining, H.; Demajo, W.; el-Ebiary, M.; Haber, J.; Hiramatsu, Y.; Nitenberg, G.; Nystrom, P. O.; Pittet, Didier; Rogers, T.; Sandven, P.; Sganga, G.; Schaller, M. D.; Solomkin, J.

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Title		Epidemiology, diagnosis and treatment of systemic Candida infection in surgical patients under intensive care
Authors		Vincent, J. L. Anaissie, E. Bruining, H. Demajo, W. el-Ebiary, M. Haber, J. Hiramatsu, Y. Nitenberg, G. Nystrom, P. O. Pittet, Didier Rogers, T. Sandven, P. Sganga, G. Schaller, M. D. Solomkin, J. show all authors [1 - 15]
Published in		Intensive Care Medicine. 1998, vol. 24, no. 3, p. 206-216
Abstract		The incidence of systemic Candida infections in patients requiring intensive care has increased substantially in recent years as a result of a combination of factors. More patients with severe underlying disease or immunosuppression from anti-neoplastic or anti-rejection chemotherapy and at risk from fungal infection are now admitted to the ICU. Improvements in supportive medical and surgical care have led to many patients who would previously have died as a result of trauma or disease surviving to receive intensive care. Moreover, some therapeutic interventions used in the ICU, most notably broad-spectrum antibiotics and intravascular catheters, are also associated with increased risks of candidiasis. Systemic Candida infections are associated with a high morbidity and mortality, but remain difficult to diagnose and ICU staff need to be acutely aware of this often insidious pathogen. A number of studies have identified risk factors for systemic Candida infection which may be used to identify those at highest risk. Such patients may be potential candidates for early, presumptive therapy. Here we review the epidemiology, pathogenesis, morbidity and mortality of systemic Candida infections in the ICU setting, and examine predisposing risk factors. Antifungal treatment, including the use of amphotericin B, flucytosine and fluconazole, and the roles of early presumptive therapy and prophylaxis, is also reviewed.
Keywords		Antifungal Agents/therapeutic use — Candidiasis/diagnosis/drug therapy/epidemiology — Causality — Cross Infection/diagnosis/drug therapy/epidemiology — Europe/epidemiology — Fungemia/diagnosis/drug therapy/epidemiology — Humans — Incidence — Infection Control — Intensive Care — Population Surveillance — Postoperative Complications/diagnosis/drug therapy/epidemiology — United States/epidemiology
Identifiers		PMID: 9565801
Full text		Article - Limited access to UNIGE Other version: http://www.springerlink.com/content/mgv8npba313elynk/?p=e691526cb3dd47c68a3aaf7393ea7d86&pi=4
Structures		Faculté de médecine / Section de médecine clinique / Département de médecine
Research group		Staphylocoques dorés résistants à la méthicilline et hygiène hospitalière (330)
Citation (ISO format)		VINCENT, J. L. et al. Epidemiology, diagnosis and treatment of systemic Candida infection in surgical patients under intensive care. In: Intensive Care Medicine, 1998, vol. 24, n° 3, p. 206-216. https://archive-ouverte.unige.ch/unige:7673