Invasive fungal infection in crtically ill patients: hurdles and next challenges

José, Peral; Álvarez-Lerma, Francisco; Maseda, Emilio; Olaechea, Pedro; Pemán, Javier; Soriano, Cruz; Zaragoza, Rafael

doi:10.1080/1120009x.2018.1557799

Cited by 15 publications

(9 citation statements)

References 60 publications

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“…There have been reports of nosocomial transmission of C. pelliculosa fungemia in the neonatal ICU,21,22 and clinicians should be vigilant about the potential presence of this species. Our study also confirmed that patients admitted to ICUs and surgical department pose a high risk of developing IFIs 17,23. MALDI-TOF MS has been extensively proven as a powerful tool in the identification of yeast species compared with traditional identification methods 12,26.…”

Section: Discussionsupporting

confidence: 83%

<p>Epidemiology And Antifungal Susceptibility Patterns Of Invasive Fungal Infections From 2012 To 2014 In A Teaching Hospital In Central China</p>

Xu¹,

Song²,

Zhou³

et al. 2019

IDR

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IntroductionAs participants of the national China Hospital Invasive Fungal Surveillance Net program, we sought to describe the epidemiology and antifungal susceptibility patterns of yeast isolates obtained from patients with invasive fungal infection at the First Affiliated Hospital of Zhengzhou University, China.MethodsA total of 434 yeast isolates recovered from blood and other sterile body ﬂuids were identified to species by matrix-assisted laser desorption ionization –time of flight mass spectrometry with or without supplementation by DNA sequencing. Antifungal susceptibilities were determined by Sensititre YeastOneTM YO10 methodology.ResultsCandida albicans was the most common causative species (33.9% of isolates) but significantly decreased in frequency from 37.2% to 27.7% from 2012 to 2014. C. tropicalis was the next most common pathogen (25.1%), followed by C. parapsilosis complex (17.3%), C. glabrata (9%), and C. pelliculosa (6.7%), with other species comprising 8% of isolates. Caspofungin, micafungin, and anidulafungin exhibited potent in vitro activities against the majority of Candida isolates. Azoles demonstrated in vitro activities against C. albicans with a susceptibility rate of >95% and against C. parapsilosis complex, >95% isolates were susceptible. Among C. tropicalis and C. glabrata isolates, resistance rates to fluconazole and voriconazole were 11.9%, 9.1% and 7.7%, 28.2%, respectively. Of note, C. pelliculosa had a high incidence rate in newborns and high rates of resistance to fluconazole and voriconazole of 55.2% and 41.4%, respectively.ConclusionThe present study provided valuable local surveillance data on the epidemiology and antifungal susceptibilities of invasive yeast species, which is essential for guiding antifungal treatment protocol development.

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Section: Discussionsupporting

confidence: 83%

<p>Epidemiology And Antifungal Susceptibility Patterns Of Invasive Fungal Infections From 2012 To 2014 In A Teaching Hospital In Central China</p>

Xu¹,

Song²,

Zhou³

et al. 2019

IDR

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“…With current detection methods, low specificity is prone to delay in diagnosis and results in high rates of missed diagnosis and misdiagnosis. It is rare for the fungal infection to invade the spine [ 4 ]. Fungal infection of the intervertebral space that leads to fungemia after the second repair surgery is even rarer.…”

Section: Discussionmentioning

confidence: 99%

A Case of Fungemia Caused by Postoperative Chronic Lumbar Intervertebral Disc Infection

Zheng

Jin

Tao

et al. 2022

Case Reports in Surgery

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Postoperative surgical site infection is one of the serious postoperative complications of spine surgery, especially fungal infections. Late-stage surgical site fungal infections often lack typical clinical symptoms and have a variable clinical presentation. In this case, the patient was a senior patient with usually only tolerable pain and discomfort, which was detected 2 years after the first surgery. Such cases are even rarer for fungal bloodstream infections caused by delayed postoperative chronic fungal osteomyelitis and deserve further study for early identification and intervention to minimize harm.

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“…In our retrospective study, 16.7% of patients with sepsis were fungal culture-positive. In short, fungal infection is still a big challenge (19).…”

Section: Discussionmentioning

confidence: 99%

Characteristics and outcomes of culture-negative versus culture-positive with fungus in sepsis patients: a retrospective analysis of the MIMIC-III database

Zou

2020

Preprint

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BACKGROUND: We compared the characteristics of culture-positive and culture-negative with fungi in septic patients to determine whether fungi culture status is associated with mortality and the relationship between antifungal therapy and sepsis patient mortality.METHODS: The study was based on the Medical Information Mart for Intensive Care (MIMIC) III database, we included all intensive care unit (ICU) admissions between 2001 and 2012 with sepsis, which met the Martin’s criteria. The primary outcome was hospital mortality. Secondary outcomes included the usage of antifungal drugs, duration of mechanical ventilation and hospital stay. Multivariable logistic regression and propensity score matching were used to investigate any association.RESULTS: The study population included 836 fungi-positive patients (16.6%) and 4191 fungi-negative patients (83.4%). Fungi-positive patients had more congestive heart failure and chronic pulmonary, higher sequential organ failure assessment (SOFA), and more need for renal replacement therapy on day one than fungi-negative patients. There was no correlation between antifungal therapy and hospital mortality (adjusted odds ratio = 1.03, 95% CI [0.89, 1.20]; P=0.676）. Hospital mortality was lower in the fungi-negative group (25.5%) than in the fungi-positive group (37.3%, P<0.001). After propensity score matching, 613 cases from each group were matched. The hospital mortality remained significantly higher in the fungi-positive group (167/613 vs. 216/613, p=0.003).CONCLUSIONS: Although residual confounding cannot be excluded, significant differences between fungi-positive and fungi-negative sepsis are identified, with the former group having more comorbidities, worse severity of illness, longer hospitalizations, and higher mortality. Antifungal therapy does not affect the outcome.

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Invasive fungal infection in crtically ill patients: hurdles and next challenges

Cited by 15 publications

References 60 publications

<p>Epidemiology And Antifungal Susceptibility Patterns Of Invasive Fungal Infections From 2012 To 2014 In A Teaching Hospital In Central China</p>

<p>Epidemiology And Antifungal Susceptibility Patterns Of Invasive Fungal Infections From 2012 To 2014 In A Teaching Hospital In Central China</p>

A Case of Fungemia Caused by Postoperative Chronic Lumbar Intervertebral Disc Infection

Characteristics and outcomes of culture-negative versus culture-positive with fungus in sepsis patients: a retrospective analysis of the MIMIC-III database

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