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[Invasive Candida infection in surgical patients: a valid clinical entity]
G Geldner1, M Ruhnke, P Lepper
1Sektion Operative Intensivmedizin, Abt. Klin. Anästhesiologie, Universitätsklinikum Ulm.
Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
|February 24, 2001
Summary
A new case definition for invasive candidosis in surgical intensive care patients is proposed. This definition aids in diagnosing Candida infections and guides future clinical studies.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Medical Microbiology
Background:
- Invasive candidosis is a serious complication in postsurgical intensive care unit (ICU) patients.
- Accurate diagnosis is crucial for effective treatment and patient outcomes.
- Existing diagnostic criteria may not be optimal for this specific patient population.
Observation:
- Eight cases of invasive candidosis were identified in a surgical ICU between 1996 and 1999.
- Common presentations included Candida peritonitis and pneumonia.
- Candida albicans was the predominant species, often in mixed infections.
Findings:
- The proposed case definition includes clinical signs, absence of bacterial pathogens, isolation of Candida from sterile sites or tracheal aspirates, response to antimycotic therapy, and a positive serum antibody test.
- Conventional serum antigen tests showed low sensitivity (2/8).
- Antimycotic therapy, primarily fluconazole, was successful in 7 out of 8 patients.
Implications:
- The proposed definition can serve as a valuable inclusion criterion for future clinical studies on invasive candidosis.
- This definition may improve the accuracy of serodiagnosis and evaluation of antimycotic chemotherapy in postsurgical ICU patients.
- Further validation in larger cohorts is warranted.