Bench-to-bedside review: Candida infections in the intensive care unit.

Détails

Ressource 1Télécharger: BIB_66EF3F7596AC.P001.pdf (194.71 [Ko])
Etat: Public
Version: de l'auteur
ID Serval
serval:BIB_66EF3F7596AC
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Synthèse (review): revue aussi complète que possible des connaissances sur un sujet, rédigée à partir de l'analyse exhaustive des travaux publiés.
Collection
Publications
Institution
Titre
Bench-to-bedside review: Candida infections in the intensive care unit.
Périodique
Critical Care
Auteur(s)
Méan M., Marchetti O., Calandra T.
ISSN
1466-609X[electronic]
Statut éditorial
Publié
Date de publication
2008
Volume
12
Numéro
1
Pages
204
Langue
anglais
Notes
Publication types: Journal Article ; Review
Résumé
Invasive mycoses are life-threatening opportunistic infections and have emerged as a major cause of morbidity and mortality in critically ill patients. This review focuses on recent advances in our understanding of the epidemiology, diagnosis and management of invasive candidiasis, which is the predominant fungal infection in the intensive care unit setting. Candida spp. are the fourth most common cause of bloodstream infections in the USA, but they are a much less common cause of bloodstream infections in Europe. About one-third of episodes of candidaemia occur in the intensive care unit. Until recently, Candida albicans was by far the predominant species, causing up to two-thirds of all cases of invasive candidiasis. However, a shift toward non-albicans Candida spp., such as C. glabrata and C. krusei, with reduced susceptibility to commonly used antifungal agents, was recently observed. Unfortunately, risk factors and clinical manifestations of candidiasis are not specific, and conventional culture methods such as blood culture systems lack sensitivity. Recent studies have shown that detection of circulating beta-glucan, mannan and antimannan antibodies may contribute to diagnosis of invasive candidiasis. Early initiation of appropriate antifungal therapy is essential for reducing the morbidity and mortality of invasive fungal infections. For decades, amphotericin B deoxycholate has been the standard therapy, but it is often poorly tolerated and associated with infusion-related acute reactions and nephrotoxicity. Azoles such as fluconazole and itraconazole provided the first treatment alternatives to amphotericin B for candidiasis. In recent years, several new antifungal agents have become available, offering additional therapeutic options for the management of Candida infections. These include lipid formulations of amphotericin B, new azoles (voriconazole and posaconazole) and echinocandins (caspofungin, micafungin and anidulafungin).
Mots-clé
Antifungal Agents, Candidiasis, Echinocandins, Hospital Mortality, Humans, Intensive Care Units, Multicenter Studies as Topic, Randomized Controlled Trials as Topic
Pubmed
Web of science
Open Access
Oui
Création de la notice
12/02/2008 11:56
Dernière modification de la notice
16/10/2019 17:22
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