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An Ex vivo Assay to Study Candida albicans Hyphal Morphogenesis in the Gastrointestinal Tract
Published on: July 1, 2020
Candidemia in Colombia
Jorge Alberto Cortés1, José Franklin Ruiz2, Lizeth Natalia Melgarejo-Moreno3
1Departamento de Medicina Interna, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, D.C., Colombia; Grupo de Investigación en Enfermedades Infecciosas, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, D.C., Colombia. jacortesl@unal.edu.co.
Abstract:
In Colombia, especially in intensive care units, candidemia is a frequent cause of infection, accounting for 88% of fungal infections in hospitalized patients, with mortality ranging from 36% to 78%. Its incidence in Colombia is higher than that reported in developed countries and even higher than in other Latin American countries. First, the patient’s risk factors should be considered, and then clinical characteristics should be assessed. Finally, microbiological studies are recommended and if the evidence supports its use, molecular testing. In general, American, Latin American, and European guides place the echinocandins as the first-line treatment for candidemia and differ in the use of fluconazole based on evidence, disease severity, previous exposure to azoles, and prevalence of Candida non-albicans. Taking into account the high incidence of this disease in our setting, it should be looked for in patients with risk factors to start a prompt empirical anti-fungal treatment.
Insights
Candidemia, a frequent fungal infection in Colombian ICUs, has high mortality. Early detection in at-risk patients and prompt antifungal treatment are crucial for better outcomes.
Area of Science:
- Infectious Diseases
- Mycology
- Critical Care Medicine
Background:
- Candidemia is a significant cause of hospital-acquired infections in Colombia, particularly in intensive care units (ICUs).
- It accounts for 88% of fungal infections in hospitalized patients, with a high mortality rate (36-78%).
- The incidence of candidemia in Colombia surpasses that reported in developed and other Latin American countries.
Purpose of the Study:
- To highlight the high burden of candidemia in Colombia.
- To emphasize the importance of early detection and prompt treatment strategies.
- To inform clinical practice regarding risk factor assessment, diagnostic approaches, and therapeutic guidelines.
Main Methods:
- Review of clinical characteristics and risk factors associated with candidemia.
- Assessment of diagnostic recommendations, including microbiological and molecular testing.
- Analysis of current international treatment guidelines for candidemia.
Main Results:
- Candidemia presents a substantial clinical challenge in Colombian ICUs due to its high incidence and mortality.
- Echinocandins are generally recommended as first-line treatment, with variations in fluconazole use based on specific patient factors and local epidemiology.
- Prompt empirical antifungal treatment is advised for patients with identified risk factors.
Conclusions:
- Early identification of patients at risk for candidemia is essential.
- Prompt initiation of antifungal therapy, guided by clinical assessment and diagnostic data, is critical.
- Adherence to established treatment guidelines, adapted for local context, can improve patient outcomes.
