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Impact of antifungal treatment on Candida-Pseudomonas interaction: a preliminary retrospective case-control study

Saad Nseir1, Elsa Jozefowicz, Béatrice Cavestri

  • 1Intensive Care Unit, Calmette Hospital, University Hospital of Lille, boulevard du Pr Leclercq, 59037, Lille cedex, France. s-nseir@chru-lille.fr

Intensive Care Medicine
|November 23, 2006
PubMed
Abstract

Insights

Antifungal treatment may reduce the risk of Pseudomonas aeruginosa ventilator-associated pneumonia (VAP) or tracheobronchial colonization in patients with Candida spp. colonization. This finding highlights a potential therapeutic strategy for co-infections.

Area of Science:

  • Medical Microbiology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Candida albicans and Pseudomonas aeruginosa exhibit pathogenic interactions.
  • Candida spp. tracheobronchial colonization is a risk factor for P. aeruginosa pneumonia.

Purpose of the Study:

  • To investigate the impact of antifungal treatment on P. aeruginosa VAP or tracheobronchial colonization.
  • To assess the role of Candida spp. colonization in the development of P. aeruginosa infections.

Main Methods:

  • Retrospective observational case-control study in a 30-bed ICU over 1 year.
  • 102 intubated patients with Candida spp. colonization were screened weekly for P. aeruginosa.
  • Matched case-control analysis (1:2) to determine risk factors.

Main Results:

  • Antifungal treatment was associated with a reduced risk of P. aeruginosa VAP/colonization (31% vs 60%, p=0.037).
  • Duration of antifungal treatment was also significantly associated with lower risk.
  • Antifungal treatment was the sole independent predictor for reduced P. aeruginosa risk (OR=0.68).

Conclusions:

  • Antifungal therapy may decrease the risk of P. aeruginosa VAP or colonization in patients with concurrent Candida spp. colonization.
  • This suggests a potential benefit of antifungal treatment in managing polymicrobial ICU infections.

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