Invasive candidiasis in intensive care units in China: Risk factors and prognoses of Candida albicans and non–albicans Candida infections

Gong, Xiaoying; Luan, Ting; Wu, Xiaojia; Li, Guofu; Qiu, Haibo; Kang, Yan; Qin, Bingyu; Fang, Qiang; Cui, Wei; Qin, Ying-zhi; Li, Jianguo; Zhang, Bin

doi:10.1016/j.ajic.2015.11.028

Cited by 53 publications

(53 citation statements)

References 41 publications

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“…The worldwide incidence of fluconazole resistance in C. parapsilosis disseminated infections ranges between 2 and 5% (Chen et al, 2006; Martí-Carrizosa et al, 2014; Pfaller et al, 2015). As C. krusei exhibits intrinsic resistance to fluconazole, there is some controversy whether its increased infection rate is related to fluconazole prophylaxis or previous treatment (Hope et al, 2002; Lin et al, 2005; Blot et al, 2006; Gong et al, 2016). Clearly, an understanding of molecular mechanisms driving intrinsic and development of high-level azole resistance is warranted.…”

Section: Azole Resistance In Candida Infectionsmentioning

confidence: 99%

Azole Antifungal Resistance in Candida albicans and Emerging Non-albicans Candida Species

et al. 2017

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Within the limited antifungal armamentarium, the azole antifungals are the most frequent class used to treat Candida infections. Azole antifungals such as fluconazole are often preferred treatment for many Candida infections as they are inexpensive, exhibit limited toxicity, and are available for oral administration. There is, however, extensive documentation of intrinsic and developed resistance to azole antifungals among several Candida species. As the frequency of azole resistant Candida isolates in the clinical setting increases, it is essential to elucidate the mechanisms of such resistance in order to both preserve and improve upon the azole class of antifungals for the treatment of Candida infections. This review examines azole resistance in infections caused by C. albicans as well as the emerging non-albicans Candida species C. parapsilosis, C. tropicalis, C. krusei, and C. glabrata and in particular, describes the current understanding of molecular basis of azole resistance in these fungal species.

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Section: Azole Resistance In Candida Infectionsmentioning

confidence: 99%

Azole Antifungal Resistance in Candida albicans and Emerging Non-albicans Candida Species

et al. 2017

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“…The most common candidemia causative species is Candida albicans , but the incidence of non‐ Candida albicans (NCA) species is increasing . Candidemia due to Candida parapsilosis and Candida tropicalis is more frequent than candidemia caused by C. albicans in some hospitals .…”

Section: Introductionmentioning

confidence: 99%

Prevalence, virulence factors and antifungal susceptibility ofCandidaspp. isolated from bloodstream infections in a tertiary care hospital in Brazil

Canela

Cardoso

Vitali

et al. 2017

Mycoses

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SummaryCandida spp. are responsible for 80% of all systemic fungal infections and are associated with high mortality rates. This study characterised 79 bloodstream isolates of C. albicans, C. glabrata, C. orthopsilosis, C. parapsilosis and C. tropicalis from patients in a Brazilian hospital. The susceptibility to amphotericin B, caspofungin, fluconazole and voriconazole was determined; virulence factor production was assessed based on haemolysin, phospholipase and proteinase activities, and the patients' clinical characteristics were analysed. C. albicans was the predominant species (44%), followed by C. glabrata (19%), C. tropicalis (19%), C. parapsilosis (14%) and C. orthopsilosis (4%). The candidemia incidence was 1.52 per 1000 admissions, and the crude mortality rate was 52%. One C. albicans isolate was resistant to fluconazole and voriconazole. Moreover, 20.2%, 2.5% and 3.8% of the isolates exhibited dosedependent susceptibility to fluconazole, voriconazole and caspofungin, respectively.In conclusion, although the C. glabrata incidence was higher than that usually described in Brazil, its increase was previously observed in studies conducted worldwide. Furthermore, the azole resistance of the C. albicans isolate could be due to previous exposure to these antifungals. These results highlight the importance of epidemiological studies and will facilitate an improved understanding of candidemia in the studied hospital. K E Y W O R D Santifungal susceptibility, Candida spp., candidemia, virulence factors

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“…Fungal sepsis greatly increases morbidity and mortality in critically ill patients (2,3). A third of all candidemias in the United States are reported in patients residing in an intensive care unit (1).…”

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confidence: 99%

Micafungin Plasma Levels Are Not Affected by Continuous Renal Replacement Therapy: Experience in Critically Ill Patients

Vossen

Knafl

Haidinger³

et al. 2017

Antimicrob Agents Chemother

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Critically ill patients often experience acute kidney injury and the need for renal replacement therapy in the course of their treatment in an intensive care unit (ICU). These patients are at an increased risk for candidiasis. Although there have been several reports of micafungin disposition during renal replacement therapy, to this date there are no data describing the elimination of micafungin during high-dose continuous venovenous hemodiafiltration with modified AN69 membranes. The aim of this prospective open-label pharmacokinetic study was to assess whether micafungin plasma levels are affected by continuous hemodiafiltration in critical ill patients using the commonly employed AN69 membrane. A total of 10 critically ill patients with micafungin treatment due to suspected or proven candidemia were included in this trial. Prefilter/postfilter micafungin clearance was measured to be 46.0 ml/min (Ϯ21.7 ml/min; n ϭ 75 individual time points), while hemofilter clearance calculated by the sieving coefficient was 0.0038 ml/min (Ϯ0.002 ml/min; n ϭ 75 individual time points). Total body clearance was measured to be 14.0 ml/min (Ϯ7.0 ml/min; n ϭ 12). The population area under the curve from 0 to 24 h (AUC 0 -24 ) was calculated as 158.5 mg · h/liter (Ϯ79.5 mg · h/liter; n ϭ 13). In spite of high protein binding, no dose modification is necessary in patients receiving continuous venovenous hemodiafiltration with AN69 membranes. A dose elevation may, however, be justified in certain cases. (This study has been registered at ClinicalTrials.gov under identifier NCT02651038.)

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Invasive candidiasis in intensive care units in China: Risk factors and prognoses of Candida albicans and non–albicans Candida infections

Cited by 53 publications

References 41 publications

Azole Antifungal Resistance in Candida albicans and Emerging Non-albicans Candida Species

Azole Antifungal Resistance in Candida albicans and Emerging Non-albicans Candida Species

Prevalence, virulence factors and antifungal susceptibility ofCandidaspp. isolated from bloodstream infections in a tertiary care hospital in Brazil

Micafungin Plasma Levels Are Not Affected by Continuous Renal Replacement Therapy: Experience in Critically Ill Patients

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