2006
DOI: 10.1016/j.annfar.2006.02.019
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La candidurie en milieu de réanimation : signification et intérêt de la numération des levures dans les urines

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Cited by 16 publications
(4 citation statements)
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“…The results indicate that ICU patients exposed to extensive gastro-abdominal surgery would benefit from early antifungal prophylaxis”Massou et al [55]Medical ICU, stay >2 days and at least one risk factor; prospective10015At admission, then weekly816 (including 143 blood cultures)CI ≥ 0.5 in 53 (53 %), predicted only by corticosteroids [OR, 5.1 (1.02–25.2)]Accuracy of CI > 0.5 in predicting IC: sens, 93 %; spec, 48 %; PPV, 26 %; NPV, 98 %Only neutropenia predicted invasive candidiasis [OR, 18.3 (2.9–114)]“CI has the advantage to provide quantified data of the patient’s situation in relation to the colonization. But, it isn’t helpful with patients having an invasive candidiasis in medical intensive care unit” Candiduria studies ( n  = 5)Chabasse [56]15 mixed ICUs, one major or two minor risk factors and candiduria; prospective1350At time of candiduria and/or candidemiaNot availableCandiduria: <10 3 , 56 (42 %); 10 3 –10 4 , 21 (16 %); >10 4 , 56 (42 %)CI > 0.5 in 36/76 tested (65 % with candiduria >10 4 , 31 % with candiduria <10 4 ; p  = 0.003)“Quantification of candiduria could be useful to select patients at high risk for disseminated candidiasis”Dubau et al [57]Surgical ICU, stay or antibiotics >7 days or postoperative fistula and CRP > 100 mg/ml; prospective891/35 empirically treated with CIs ≥ 0.5; 0 with CIs < 0.5; 22 candiduriaOn inclusion, then weekly2,238Absence of candiduria: CI = 0.3–0.47 ( p  = 0.008)Presence of candiduria: CI = 0.57–0.87 ( p  = 0.0001)“The presence of a candiduria was significantly associated with an increased invasive candidiasis”Sellami et al [58]Mixed ICU, stay >3 days; prospective1626; 56 candiduriaOn inclusion, then weeklyNot availableCandiduria: <10 3 , 12 (21 %); 10 3 –10 4 , 16 (29 %); >10 4 , 28 (50 %)Mean CI = 0.47 candiduria, 0.8 IC ( n  = 6)CI > 0.5 in 67 % candiduria >10 4 “Candiduria superior or equal to 10 4  UFC/ml associated with risk factors may predict invasive candidiasis in critically ill patients”Charles et al [38]Medical ICU, stay > 7 days; prospective929Weekly1,696 (mean, 18.4/patient)…”
Section: Overview Of the Usefulness Of The Colonization Indexmentioning
confidence: 99%
“…The results indicate that ICU patients exposed to extensive gastro-abdominal surgery would benefit from early antifungal prophylaxis”Massou et al [55]Medical ICU, stay >2 days and at least one risk factor; prospective10015At admission, then weekly816 (including 143 blood cultures)CI ≥ 0.5 in 53 (53 %), predicted only by corticosteroids [OR, 5.1 (1.02–25.2)]Accuracy of CI > 0.5 in predicting IC: sens, 93 %; spec, 48 %; PPV, 26 %; NPV, 98 %Only neutropenia predicted invasive candidiasis [OR, 18.3 (2.9–114)]“CI has the advantage to provide quantified data of the patient’s situation in relation to the colonization. But, it isn’t helpful with patients having an invasive candidiasis in medical intensive care unit” Candiduria studies ( n  = 5)Chabasse [56]15 mixed ICUs, one major or two minor risk factors and candiduria; prospective1350At time of candiduria and/or candidemiaNot availableCandiduria: <10 3 , 56 (42 %); 10 3 –10 4 , 21 (16 %); >10 4 , 56 (42 %)CI > 0.5 in 36/76 tested (65 % with candiduria >10 4 , 31 % with candiduria <10 4 ; p  = 0.003)“Quantification of candiduria could be useful to select patients at high risk for disseminated candidiasis”Dubau et al [57]Surgical ICU, stay or antibiotics >7 days or postoperative fistula and CRP > 100 mg/ml; prospective891/35 empirically treated with CIs ≥ 0.5; 0 with CIs < 0.5; 22 candiduriaOn inclusion, then weekly2,238Absence of candiduria: CI = 0.3–0.47 ( p  = 0.008)Presence of candiduria: CI = 0.57–0.87 ( p  = 0.0001)“The presence of a candiduria was significantly associated with an increased invasive candidiasis”Sellami et al [58]Mixed ICU, stay >3 days; prospective1626; 56 candiduriaOn inclusion, then weeklyNot availableCandiduria: <10 3 , 12 (21 %); 10 3 –10 4 , 16 (29 %); >10 4 , 28 (50 %)Mean CI = 0.47 candiduria, 0.8 IC ( n  = 6)CI > 0.5 in 67 % candiduria >10 4 “Candiduria superior or equal to 10 4  UFC/ml associated with risk factors may predict invasive candidiasis in critically ill patients”Charles et al [38]Medical ICU, stay > 7 days; prospective929Weekly1,696 (mean, 18.4/patient)…”
Section: Overview Of the Usefulness Of The Colonization Indexmentioning
confidence: 99%
“…Candida albicans has played an important role in candiduria (1,2), however during the last decades non-albicans, such as C. glabrata, and C. tropicalis, have gradually increased in the incidence of nosocomial infections (1,(3)(4)(5)(6). Old age, long stayin hospital, using broad spectrum antibiotics, and renal defects are the most important predisposing factors for candiduria (1,5,7,8). Several reports have indicated that candiduria is a very common infection in hospitalized patients and its incidence is linked to antibiotic usage, long stay in hospitals, old age etc (2,6,9).…”
Section: Introductionmentioning
confidence: 99%
“…Atualmente, ainda não há metodologia fidedigna e segura para diferenciar colonização de infecção na presença de uma candidúria detectada em laboratório (10) . Para alguns, somente a simples presença de leveduras em uroculturas ou o exame direto já é suficiente para definir infecção (81) . No entanto, em alguns estudos a quantificação torna-se um dos critérios para a obtenção de tal definição, havendo ainda controvérsias para se estabelecer um valor-padrão.…”
Section: Diagnóstico Laboratorial Para Detecção De Levedurasunclassified