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An Ex vivo Assay to Study Candida albicans Hyphal Morphogenesis in the Gastrointestinal Tract
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Published on: July 1, 2020

[Invasive fungal infection in critically ill patients]

José Garnacho-Montero1, Ana Díaz-Martín, Maite Ruiz-Pérez De Piappón

  • 1Unidad de Gestión Clínica de Cuidados Críticos y Urgencias, Hospital Universitario Virgen del Rocío, Sevilla, España. jose.garnacho.sspa@juntadeandalucia.es

Enfermedades Infecciosas Y Microbiologia Clinica
|April 17, 2012
PubMed

Insights

Candida species cause fungal infections in critically ill patients, with Candida albicans being most common. Early diagnosis and targeted antifungal therapy are crucial for invasive candidiasis management.

Area of Science:

  • Infectious Diseases
  • Critical Care Medicine
  • Mycology

Context:

  • Candida species are the most common cause of fungal infections in critically ill patients.
  • Candida colonization is prevalent in ICUs, affecting nearly 60% of non-neutropenic patients with prolonged stays.
  • Invasive candidiasis develops in only 5% of colonized patients, highlighting diagnostic challenges.

Purpose:

  • To summarize current understanding and management strategies for invasive candidiasis in critically ill patients.
  • To emphasize the significance of Candida detection in blood cultures and the need for prompt treatment.
  • To provide guidance on antifungal therapy selection based on patient condition and prior azole exposure.

Summary:

  • Candida spp., particularly C. albicans, are leading causes of fungal infections in the ICU.
  • While colonization is common, invasive disease is less frequent, posing diagnostic difficulties.
  • Bloodstream Candida should always prompt treatment; multifocal colonization with a high Candida score warrants antifungal therapy.
  • Treatment decisions involve patient severity and azole exposure history, with echinocandins recommended for unstable patients.

Impact:

  • Improved diagnostic approaches for invasive non-candidemic candidiasis.
  • Optimized antifungal stewardship in intensive care units.
  • Reduced morbidity and mortality associated with invasive candidiasis in critically ill populations.

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