Nosocomial Candidemia: An Ounce of Prevention Is Better Than a Pound of Cure

Diekema, Daniel J.; Pfaller, Michael A.

doi:10.1086/502451

Cited by 57 publications

(59 citation statements)

References 42 publications

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“…The weight of the evidence provided by these studies suggests that IC is associated with an important attributable mortality (308). Furthermore, these data demonstrate that IC carries no less risk of death during hospitalization today than it did in the 1980s and early 1990s (59). These estimates of attributable mortality are comparable to those for infectious diseases for which large-scale preventative efforts have been made to reduce the incidence and mortality of infection, arguing for increased efforts in candidemia prevention (59,83,178,307,327).…”

Section: Excess Mortality Los and Cost Of Icmentioning

confidence: 74%

“…The discrepancy between rates of infection in black and white infants may be due in part to the elevated incidence of prematurity and low birth weight among black infants (92,113). These data suggest that certain groups have an incidence of IC so high that serious consideration should be given to prophylactic or preemptive therapy (59,92,116,117,233,270).…”

Section: Incidence Of Ic From Population-based Surveillancementioning

confidence: 94%

“…Candida infections are associated with a high crude mortality of 46% to 75%, reflecting the severe underlying illnesses of the infected patients (59,67,70,195,321). Given the complex nature of these patients' conditions, it has been difficult to assess the resultant increase in mortality, length of hospital stay (LOS), and costs attributable to the candidal infection (164).…”

Section: Excess Mortality Los and Cost Of Icmentioning

confidence: 99%

“…Given the complex nature of these patients' conditions, it has been difficult to assess the resultant increase in mortality, length of hospital stay (LOS), and costs attributable to the candidal infection (164). In order to better estimate the contribution of the infectious process to mortality, LOS, and costs of care, one must conduct matched-cohort studies where the case patients are carefully matched to control subjects for all variables except for the candidal infections (59,89,164,195,238,307,308,327). The absolute difference in mortality, LOS, or costs between the case patients and control subjects who were matched for underlying disease is the attributable mortality rate or the excess LOS and cost attributable to the infection (164,308).…”

Section: Excess Mortality Los and Cost Of Icmentioning

confidence: 99%

“…Since the early 1980s, fungi have emerged as major causes of human disease, especially among the immunocompromised and those hospitalized with serious underlying disease (23,59,70,80,154,175,205,211,242,266,315). A recent study of the epidemiology of sepsis found that the annual number of cases of sepsis caused by fungal organisms in the United States increased by 207% between 1979 and 2000 (150).…”

Section: Introductionmentioning

confidence: 99%

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Epidemiology of Invasive Candidiasis: a Persistent Public Health Problem

2007

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SUMMARY Invasive candidiasis (IC) is a leading cause of mycosis-associated mortality in the United States. We examined data from the National Center for Health Statistics and reviewed recent literature in order to update the epidemiology of IC. IC-associated mortality has remained stable, at approximately 0.4 deaths per 100,000 population, since 1997, while mortality associated with invasive aspergillosis has continued to decline. Candida albicans remains the predominant cause of IC, accounting for over half of all cases, but Candida glabrata has emerged as the second most common cause of IC in the United States, and several less common Candida species may be emerging, some of which can exhibit resistance to triazoles and/or amphotericin B. Crude and attributable rates of mortality due to IC remain unacceptably high and unchanged for the past 2 decades. Nonpharmacologic preventive strategies should be emphasized, including hand hygiene; appropriate use, placement, and care of central venous catheters; and prudent use of antimicrobial therapy. Given that delays in appropriate antifungal therapy are associated with increased mortality, improved use of early empirical, preemptive, and prophylactic therapies should also help reduce IC-associated mortality. Several studies have now identified important variables that can be used to predict risk of IC and to help guide preventive strategies such as antifungal prophylaxis and early empirical therapy. However, improved non-culture-based diagnostics are needed to expand the potential for preemptive (or early directed) therapy. Further research to improve diagnostic, preventive, and therapeutic strategies is necessary to reduce the considerable morbidity and mortality associated with IC.

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Section: Excess Mortality Los and Cost Of Icmentioning

confidence: 74%

Section: Incidence Of Ic From Population-based Surveillancementioning

confidence: 94%

Section: Excess Mortality Los and Cost Of Icmentioning

confidence: 99%

Section: Excess Mortality Los and Cost Of Icmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Epidemiology of Invasive Candidiasis: a Persistent Public Health Problem

2007

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Role of Aif1 in regulation of cell death under environmental stress in Candida albicans

Zhang

Wang

et al. 2016

Yeast

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Apoptosis-inducing factor (AIF) is a conserved flavoprotein localized in the mitochondria, inducing apoptosis after translocation into the nucleus. However, its role in the important fungal pathogen, Candida albicans, remains to be investigated. In this study, we find that the C. albicans AIF protein Aif1, similar to its homologues in other organisms, is localized at the mitochondria and translocated into the nucleus under apoptosis-inducing conditions. Moreover, deletion of AIF1 causes attenuated apoptosis in this pathogen under apoptosis-inducing conditions, such as the treatment of 2 mm H2 O2 , 10 mm acetic acid or 0.08 mg/l caspofungin, and its overexpression enhances this process. Interestingly, treatment with high levels of these agents leads to reversed sensitivity of aif1Δ/Δ and the overexpression strain AIF1ov. In addition, the virulence of C. albicans is not affected by deletion or overexpression of AIF1. Hence, C. albicans Aif1, as a mitochondria-localized protein, plays a dual role in the regulation of cell death under different concentrations of the stress-caused agents. Copyright © 2016 John Wiley & Sons, Ltd.

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