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Published on: July 1, 2020
[Fungal infections in the intensive care unit]
Klaus Kerwat1, Caroline Rolfes, Hinnerk Wulf
1Klinik für Anästhesie und Intensivtherapie, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg.
Abstract:
Invasive infections through to sepsis caused by fungi in intensive care units have increased markedly in the past few years. In the mean time almost every tenth case of sepsis in the intensive care unit is the result of an invasive fungal infection. Not only hemato-oncological or organ-transplanted patients are affected but increasingly also those patients who have been under intensive care for a considerable time and who exhibit particular risk factors. The lethality among the afflicted patients is high. The diagnosis of fungal infections is still difficult; unambiguous, highly sensitive and specific test procedures are still lacking. The decision for therapy must often be made empirically and as early as possible. In the past few years newly developed antimycotic agents have opened up new options for therapy.
Insights
Fungal sepsis in intensive care units (ICUs) is rising, impacting non-traditional patients. Early diagnosis and new antifungal treatments are crucial due to high mortality and diagnostic challenges.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Critical Care Medicine
Context:
- Increasing incidence of invasive fungal infections (IFIs) leading to sepsis in intensive care units (ICUs).
- IFIs now represent a significant proportion (nearly 10%) of sepsis cases in ICUs.
- At-risk populations extend beyond immunocompromised individuals to include long-term ICU patients with specific risk factors.
Purpose:
- To highlight the growing threat of fungal sepsis in ICUs.
- To underscore the diagnostic difficulties and high lethality associated with IFIs.
- To introduce the potential of novel antifungal agents in managing these infections.
Summary:
- Fungal sepsis cases in ICUs have significantly increased, with nearly 10% of ICU sepsis cases now attributed to invasive fungal infections.
- These infections affect a broader patient group than previously recognized, including those with prolonged ICU stays and specific risk factors.
- High mortality rates and diagnostic challenges necessitate prompt, often empirical, therapeutic decisions, with new antifungal agents offering improved treatment options.
Impact:
- Emphasizes the urgent need for improved diagnostic tools for fungal infections in critical care settings.
- Highlights the importance of considering fungal pathogens in sepsis management protocols for ICU patients.
- Suggests that advancements in antifungal therapies may improve outcomes for patients with invasive fungal infections in ICUs.
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