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Detection of Invasive Pulmonary Aspergillosis in Haematological Malignancy Patients by using Lateral-flow Technology
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Invasive fungal infection in crtically ill patients: hurdles and next challenges

Peral José1, Francisco Alvarez-Lerma2, Emilio Maseda3

  • 1a Intensive Care Unit , Hospital General Universitario Gregorio Marañón , Madrid , Spain.

Journal of Chemotherapy (Florence, Italy)
|February 15, 2019
PubMed

Insights

Invasive fungal infections (IFIs) are a growing threat in critical care, particularly with emerging resistant species like Candida auris. Multidisciplinary strategies are crucial to combat rising IFI incidence and mortality in vulnerable patients.

Area of Science:

  • Critical Care Medicine
  • Clinical Mycology

Background:

  • Emergence of multidrug-resistant Candida auris globally, causing hospital outbreaks.
  • Increased incidence of invasive fungal infections (IFIs) in patients on extracorporeal membrane oxygenation (ECMO).
  • Invasive aspergillosis is a significant life-threatening infection in intensive care units (ICUs).

Purpose of the Study:

  • To review the current landscape of invasive fungal infections in critically ill patients.
  • To highlight challenges including emerging resistant species and treatment failures.
  • To emphasize the need for multidisciplinary approaches to manage IFIs.

Main Methods:

  • Narrative review conducted by a multidisciplinary task force.
  • Expert review of current literature on IFIs in critical care.
  • Analysis of emerging risk factors, species, and resistance patterns.

Main Results:

  • Candida auris outbreaks are occurring in critically ill patients.
  • Suboptimal antifungal concentrations may contribute to treatment failures.
  • New risk factors are associated with invasive aspergillosis in ICUs.

Conclusions:

  • IFIs pose a significant and increasing problem in critical care.
  • New risk factors, species, and antifungal resistance necessitate updated management strategies.
  • Multidisciplinary interventions and improved diagnostics are vital to reduce IFI incidence and mortality.
Keywords:
Antifungal treatmentAspergillosisCandidiasisChallengesICUInvasive fungal infections

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