Related Experiment Videos
Fungal sepsis: multisite colonization versus fungemia
G J Slotman1, E Shapiro, S M Moffa
1Department of Surgery, Cooper Hospital/University Medical Center, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School at Camden 08103.
The American Surgeon
|February 1, 1994
Summary
Systemic fungal infections in critically ill patients have unclear treatment guidelines. Amphotericin B improved survival for fungemia, but its use in fungal colonization increased mortality, highlighting the need for better treatment strategies.
Area of Science:
- Critical Care Medicine
- Infectious Diseases
- Medical Mycology
Background:
- Systemic fungal infections and colonization present significant challenges in critically ill patients.
- Optimal therapeutic strategies for these conditions remain poorly defined.
Purpose of the Study:
- To retrospectively evaluate patient management and outcomes in critically ill individuals with multiple sites of fungal colonization and/or fungemia.
- To determine the effectiveness of different antifungal treatment regimens.
Main Methods:
- Retrospective review of medical records for 36 fungemic patients and 76 fungus-colonized patients with at least two colonized sites.
- Analysis of patient demographics, surgical procedures, concomitant infections, antifungal therapies, and mortality rates.
Main Results:
- Mortality rates were similar between fungemic (47%) and fungus-colonized (41%) patients.
- Amphotericin B significantly reduced mortality in fungemic patients (26% vs. 71%, P < 0.05).
- In fungus-colonized patients, Amphotericin B was associated with higher mortality (70% vs. 36%, P < 0.05), while other antifungals showed no significant impact.
Conclusions:
- Multisite fungal colonization carries a mortality risk comparable to fungemia.
- Amphotericin B is the only antifungal agent demonstrated to improve survival in fungemia.
- The optimal treatment for multisite fungal colonization requires further investigation.