Diagnosis of invasive candidiasis in the ICU.

Détails

Ressource 1Télécharger: BIB_9E2018780C4A.P001.pdf (331.30 [Ko])
Etat: Public
Version: de l'auteur
ID Serval
serval:BIB_9E2018780C4A
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
Diagnosis of invasive candidiasis in the ICU.
Périodique
Annals of Intensive Care
Auteur(s)
Eggimann P., Bille J., Marchetti O.
ISSN
2110-5820 (Electronic)
ISSN-L
2110-5820
Statut éditorial
Publié
Date de publication
2011
Peer-reviewed
Oui
Volume
1
Pages
37
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: epublish. PDF type: Review
Résumé
Invasive candidiasis ranges from 5 to 10 cases per 1,000 ICU admissions and represents 5% to 10% of all ICU-acquired infections, with an overall mortality comparable to that of severe sepsis/septic shock. A large majority of them are due to Candida albicans, but the proportion of strains with decreased sensitivity or resistance to fluconazole is increasingly reported. A high proportion of ICU patients become colonized, but only 5% to 30% of them develop an invasive infection. Progressive colonization and major abdominal surgery are common risk factors, but invasive candidiasis is difficult to predict and early diagnosis remains a major challenge. Indeed, blood cultures are positive in a minority of cases and often late in the course of infection. New nonculture-based laboratory techniques may contribute to early diagnosis and management of invasive candidiasis. Both serologic (mannan, antimannan, and betaglucan) and molecular (Candida-specific PCR in blood and serum) have been applied as serial screening procedures in high-risk patients. However, although reasonably sensitive and specific, these techniques are largely investigational and their clinical usefulness remains to be established. Identification of patients susceptible to benefit from empirical antifungal treatment remains challenging, but it is mandatory to avoid antifungal overuse in critically ill patients. Growing evidence suggests that monitoring the dynamic of Candida colonization in surgical patients and prediction rules based on combined risk factors may be used to identify ICU patients at high risk of invasive candidiasis susceptible to benefit from prophylaxis or preemptive antifungal treatment.
Pubmed
Web of science
Open Access
Oui
Création de la notice
02/02/2012 17:14
Dernière modification de la notice
20/08/2019 16:04
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