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Postoperative fungal infections

Philippe Eggimann1, Didier Pittet

  • 1Department of Critical Care Medicine and Burn Unit, Interdisciplinary Department for Support and Techniques, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. philippe.eggimann@chuv.ch

Surgical Infections
|August 10, 2006
PubMed
Abstract

Insights

Identifying surgical patients at high risk for invasive candidiasis is crucial. Restricting empiric treatment and prophylaxis to these select individuals prevents unnecessary use and the emergence of resistant Candida strains.

Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Surgical Infections

Background:

  • Post-surgical patients frequently experience Candida spp. colonization, but invasive candidiasis develops in a minority.
  • Late manifestation of severe infection symptoms complicates early diagnosis.
  • Emergence of non-albicans Candida strains is a growing concern due to improved treatments and antifungal resistance.

Purpose of the Study:

  • To identify clinical criteria for predicting invasive candidiasis in surgical patients.
  • To determine optimal strategies for managing Candida colonization post-surgery.
  • To reduce the incidence of invasive candidiasis and antifungal resistance.

Main Methods:

  • Genotyping to confirm endogenous sources of Candida colonization.
  • Evaluation of diagnostic tools for differentiating colonization from infection.
  • Assessment of the colonization index as a predictive tool.

Main Results:

  • Endogenous colonization is the primary source for most invasive candidiasis cases.
  • A significant challenge exists in identifying the subgroup of colonized patients who will develop invasive candidiasis.
  • Current biological diagnostic tools have not improved early detection.

Conclusions:

  • Empiric treatment for Candida colonization post-surgery should be reserved for patients with a high predicted risk of invasive candidiasis.
  • Prophylaxis should be administered only to patients demonstrating proven efficacy.
  • Targeted treatment strategies are essential to combat invasive candidiasis and prevent resistance.

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