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Fungal infections in the ICU

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Abstract

Data collected over the past 10–20 years clearly show that invasive fungal infections, far from being observed in immunocompromised hosts only, are increasingly recognised as a growing problem in critically ill nonimmunocompromised patients and in subjects undergoing major surgical procedures [13]. While Candida spp. are the most common cause of severe fungal infections in the ICU, mould infections are so far rare, but the problem is rapidly rising due to the increased spectrum of patients at risk for aspergillar infections [4]. According to Vanderwoude [5], this particular group of patients has recently been categorised into different risk classes: high risk (allogeneic bone marrow-transplanted patients, neutropenic and haematological patients); intermediate risk (autologous bone marrow-transplanted patients, subjects suffering from malnutrition, under corticosteroid therapy, with diabetes or underlying pulmonary diseases) and low risk (patients suffering for cystic fibrosis and connective tissue disease). Cases of invasive pulmonary aspergillosis have been reported in apparently nonimmunocompromised COPD patients [5].

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References

  1. Eggimann P, Garbino J, Pittet D (2003) Epidemiology of Candida species infections in critically ill nonimmunosuppressed patients. Lancet Infect Dis 3:685–702

    Article  PubMed  Google Scholar 

  2. Svoboda P, Kantarova I (2006) Systemic Candida infection in the ICU. In: Vincent JL (ed): Yearbook of intensive care and emergency medicine. Springer, New York Berlin Heidelberg, pp 595–603

    Chapter  Google Scholar 

  3. Playford GE, Webster AC, Sorrell TC, Craig JC (2006) Antifungal agents for preventing fungal infections in the non-neutropenic critically ill and surgical patients: systematic review and meta-analysis of randomized clinical trials. J Antimicrob Chemioter 57:628–638

    Article  CAS  Google Scholar 

  4. Meersseman W, Wilmer A, Peetersman WE (2004) The spectrum of invasive aspergillosis in the ICU: not just for haematology patients. In: Vincent JL (ed) Yearbook of intensive care and emergency medicine. Springer, New York Berlin Heidelberg, pp 258–264

    Google Scholar 

  5. Vandewoude KH, Blot SI, Depuydt P et al (2006) Clinical relevance of Aspergillus isolation from respiratory tract sample in critically ill patients. Crit Care 10:R31 (doi:10.1186/cc4823)

    Article  PubMed  Google Scholar 

  6. Tortorano AM, Caspani L, Rigoni AL et al (2004). Candidosis in the ICU: a 20 years survey. J Hosp Infect 57:8–13

    Article  PubMed  CAS  Google Scholar 

  7. Eggimann P, Calandra T, Flickiger U et al (2005). Invasive candidiasis: comparison of management choices by infectious disease and critical care specialists. Intensive Care Med, 31:1514–1521

    Article  PubMed  Google Scholar 

  8. Ostrosky Zeichner L (2003) New approaches to the risk of Candida in the ICUs. Curr Opin Infect Dis 16:533–537

    Article  PubMed  Google Scholar 

  9. Martin GS, Mannino DM, Eaton S, Moss M (2003) Epidemiology of sepsis in the US from 1979 through 2000. N Engl J Med 348:1546

    Article  PubMed  Google Scholar 

  10. Blumberg HM, Jarvis WR, Soucie M et al (2001) Risk factors for the Candida bloodstream infections in surgical ICUs patients: the NEMIS prospective multicenter study. Clin Infect Dis 33:177–186

    Article  PubMed  CAS  Google Scholar 

  11. Vincent JL, Bihari DJ, Suter PM et al (1995) The prevalence of nosocomial infection in ICUs in Europe. Results of EPIC Study. JAMA 274:639–644

    Article  PubMed  CAS  Google Scholar 

  12. Alberti C, Brun-Buisson VC, Burchardi H et al (2003) Epidemiology of sepsis and infarction in ICU patients from an international multicenter cohort study. Intensive Care Med 28:108–121

    Article  Google Scholar 

  13. Leleu G, Aegerter P, Guidet B (2002) Systemic candidiasis in ICU: a multicenter matched cohort study. J Crit Care 17:168–175

    Article  PubMed  Google Scholar 

  14. Luzzaro F, Viganò EF, Fossati D et al (2002) Prevalence and drug susceptibility of pathogens causing bloodstream infections in northern Italy: a two years study in 16 hospitals. Eur J Clin Microbiol Dis 21:849–855

    CAS  Google Scholar 

  15. Tortorano A, Kibbler C, Peman A et al (2006) Candidemia in Europe: epidemiology and resistance. Int J Antimicrob Agents 27:359–366

    Article  PubMed  CAS  Google Scholar 

  16. Marchetti O, Bille J, Fluckinger U et al (2004) Epidemiology of Candida in Swiss tertiary care hospital: secular trends 1991–2000. Clin Infect Dis 38:311–320

    Article  PubMed  Google Scholar 

  17. Pittet D, Monod M, Suter PM et al (1994) Candida colonization and subsequent infections in critically ill surgical patients. Ann Surg 220:751–758

    Article  PubMed  CAS  Google Scholar 

  18. Edwards J (1997) International conference on the development of a consensus on the management and prevention of severe candidal infections. Clin Infect Dis 25:43–59

    Article  PubMed  Google Scholar 

  19. Snydman DR (2003) Shifting patterns in the epidemiology of nosocomial Candida infections. Chest 123:500S–503S

    Article  PubMed  Google Scholar 

  20. Tortorano C, Peman A, Bernhardt A and the ECMM Working group on Candidemia (2004) Epidemiology of candidemia in Europe: results of 28 months ECMM hospitalbased surveillance study. Eur J Clin Microbiol Infect Dis 23:317–322

    Article  PubMed  CAS  Google Scholar 

  21. Eggimann P, Pittet D (2006) Candida colonization index in the management of critically ill patients. In: Vincent JL (ed) Yearbook of intensive care and emergency medicine. Springer, New York Berlin Heidelberg, pp 604–612

    Chapter  Google Scholar 

  22. Lipsett P (2002) Fungal infections in surgical patients. Prob Gen Surg 19:92–102

    Article  Google Scholar 

  23. Eggimann P, Garbino J, Pittet D (2003) Management of Candida species infections in critically ill non immunosuppressed patients. Lancet Infect Dis 3:772–785

    Article  PubMed  CAS  Google Scholar 

  24. Pappas PG, Rex JH, Sobel JD et al (2004) Guidelines for treatment of candidiasis. Clin Infect Dis 38:161–189

    Article  PubMed  Google Scholar 

  25. Rex JH, Sobel JD(2001) Prophylactic antifungal therapy in ICU. Clin Infect Dis 32:1191–1200

    Article  PubMed  CAS  Google Scholar 

  26. Blot S, Vanderwoude K (2004) Management of invasive candidiasis in critically ill patients. Drugs 64:2159–2171

    Article  PubMed  CAS  Google Scholar 

  27. Jones BL, McLintock AL (2003) Impact of diagnostic markers on early antifungal therapy. Curr Opin Infect Dis 16:521–526

    Article  PubMed  CAS  Google Scholar 

  28. Leon C, Ruiz Santana S, Saavedra P et al (2006) A bedside scoring system (Candida scoring system) for early antifungal treatment in nonneutropenic critically ill patients with Candida colonization. Crit Care Med 34:730–737

    Article  PubMed  Google Scholar 

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© 2007 Springer-Verlag Italia

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De Gasperi, A., Corti, A., Perrone, L. (2007). Fungal infections in the ICU. In: Gullo, A. (eds) Anaesthesia, Pain, Intensive Care and Emergency A.P.I.C.E.. Springer, Milano. https://doi.org/10.1007/978-88-470-0571-6_15

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  • DOI: https://doi.org/10.1007/978-88-470-0571-6_15

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-0570-9

  • Online ISBN: 978-88-470-0571-6

  • eBook Packages: MedicineMedicine (R0)

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