Effect of first-line antifungal treatment on ocular complication risk in<i>Candida</i>or yeast blood stream infection

Hautala, Nina; Köykkä, Hannu; Siiskonen, Mira; Saari, Juho; Kauranen, Jari; Hautala, Timo

doi:10.1136/bmjophth-2021-000837

Cited by 5 publications

(1 citation statement)

References 19 publications

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“…A novel echinocandin rezafungin with once-weekly dosing and activity against Candida spp., including subsets of echinocandin-resistant Candida auris , has been recently developed and is currently in phase III trials [ 170 , 171 , 172 , 173 , 174 , 175 , 176 ]. Echinocandins demonstrate wide distribution in different organs and tissues, except the brain and eyes [ 52 , 177 ].…”

Section: Treatment Of Invasive Candidiasismentioning

confidence: 99%

Diagnosis and Treatment of Invasive Candidiasis

Barantsevich

2022

Antibiotics

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Candida species, belonging to commensal microbial communities in humans, cause opportunistic infections in individuals with impaired immunity. Pathogens encountered in more than 90% cases of invasive candidiasis include C. albicans, C. glabrata, C. krusei, C. tropicalis, and C. parapsilosis. The most frequently diagnosed invasive infection is candidemia. About 50% of candidemia cases result in deep-seated infection due to hematogenous spread. The sensitivity of blood cultures in autopsy-proven invasive candidiasis ranges from 21% to 71%. Non-cultural methods (beta-D-glucan, T2Candida assays), especially beta-D-glucan in combination with procalcitonin, appear promising in the exclusion of invasive candidiasis with high sensitivity (98%) and negative predictive value (95%). There is currently a clear deficiency in approved sensitive and precise diagnostic techniques. Omics technologies seem promising, though require further development and study. Therapeutic options for invasive candidiasis are generally limited to four classes of systemic antifungals (polyenes, antimetabolite 5-fluorocytosine, azoles, echinocandins) with the two latter being highly effective and well-tolerated and hence the most widely used. Principles and methods of treatment are discussed in this review. The emergence of pan-drug-resistant C. auris strains indicates an insufficient choice of available medications. Further surveillance, alongside the development of diagnostic and therapeutic methods, is essential.

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Section: Treatment Of Invasive Candidiasismentioning

confidence: 99%

Diagnosis and Treatment of Invasive Candidiasis

Barantsevich

2022

Antibiotics

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A Scoping Review of the Changing Epidemiology and Risk Factors of Endogenous Candida Ocular Infections

Pek¹,

Bork²

2023

Curr Fungal Infect Rep

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Prevalence of Ocular Candidiasis and Candida Endophthalmitis in Patients With Candidemia: A Systematic Review and Meta-Analysis

Phongkhun

Pothikamjorn

Srisurapanont

et al. 2023

Clinical Infectious Diseases

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Background Infectious diseases and ophthalmology professional societies have disagreed regarding ocular screening in patients with candidemia. This study aimed to summarize the current evidence on the prevalence of ocular candidiasis (OC) and Candida endophthalmitis (CE) according to the standardized definitions. Methods A literature search was conducted from the 1990s through October 16th, 2022, using PubMed, Embase, and SCOPUS. Pooled prevalence of ocular complications was derived from generalized linear mixed models. (PROSPERO CRD42022326610) Results A total of 70 and 35 studies were included in the meta-analysis for OC and concordant CE (chorioretinitis with vitreous involvement), respectively. This study represented 8,599 patients with candidemia who underwent ophthalmologic examination. The pooled prevalence [95% confidence interval] of OC, overall CE, concordant CE, and discordant CE were 10.7% [8.4%-13.5%], 3.1% [2.1%-4.5%], 1.8% [1.3%-2.6%], and 7.4% [4.5%-12%] of patients screened, respectively. Studies from Asian countries had significantly higher concordant CE prevalence of patients screened [95% CI] of 3.6% [2.9% - 4.6%] compared to studies from European countries of 1.4% [0.4% - 5%] and American countries of 1.4% [0.9% - 2.2%], p-value <0.01. Presence of total parenteral nutrition and C. albicans were associated with CE with pooled odds ratios [95% CI] of 6.92 [3.58–13.36] and 3.02 [1.67–5.46], respectively. Conclusion Prevalence of concordant CE overall and among Asian countries was two-times and four-times higher than the prevalence previously reported by American Academy of Ophthalmology of < 0.9%, respectively. There is an urgent need to study optimal screening protocols and to establish joint recommendations by the Infectious Diseases and Ophthalmology Societies.

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Effect of first-line antifungal treatment on ocular complication risk inCandidaor yeast blood stream infection

Cited by 5 publications

References 19 publications

Diagnosis and Treatment of Invasive Candidiasis

Diagnosis and Treatment of Invasive Candidiasis

A Scoping Review of the Changing Epidemiology and Risk Factors of Endogenous Candida Ocular Infections

Prevalence of Ocular Candidiasis and Candida Endophthalmitis in Patients With Candidemia: A Systematic Review and Meta-Analysis

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