Occurrence, presentation and treatment of candidemia

Abstract

Candida is one of the most common causes of nosocomial bloodstream infections. Candidemia is not confined to hematological patients, intensive care units or abdominal surgery wards, but it is remarkably frequent in the internal medicine setting. High mortality associated with candidemia can be reduced by prompt, appropriate antifungal therapy. The epidemiology of species has been shifting toward non-albicans strains. Significant improvements in nonculture-based diagnostic methods, such as serological markers, have been made in recent years, and novel diagnostic techniques should be further studied to enable early pre-emptive therapy. Treatment guidelines indicate that echinocandins are at present the best choice for patients who are severely ill or possibly infected with fluconazole-resistant strains.

The Differences in the Epidemiology and Predictors of Death between Candidemia Acquired in Intensive Care Units and Other Hospital Settings

“…In intensive care units (ICUs), candidemia is a serious problem, and an estimated 33% to 55% of all episodes occur in ICUs (5,6). However, the incidence of candidemia has increased over the last decade in non-ICU populations, and the burden of candidemia is shifting from ICUs to general hospital wards (7)(8)(9). A number of studies from different regions have provided endemic epidemiology data regarding candidemia in ICU populations or other atrisk populations (10)(11)(12)(13)(14)(15), but comparisons between ICUacquired candidemia (ICUAC) and non-ICUAC in a single region remain scarce.…”

Discrimination of Candida species by paper spray mass spectrometry

“…Candida is one of the most common etiological agents of nosocomial bloodstream infections (candidemia) which are a major cause of in-hospital morbidity and mortality [1][2][3][4]. The prevalence of candidemia has been reported to be approximately 6.9 per 1000 patients [2,5].…”

“…The prevalence of candidemia has been reported to be approximately 6.9 per 1000 patients [2,5]. Invasive candidemia is life-threatening with a high mortality rate (30-40%) which can be decreased by appropriate and timely antibiotic therapy [1,2,[5][6][7][8][9][10][11].…”

“…Invasive candidemia is life-threatening with a high mortality rate (30-40%) which can be decreased by appropriate and timely antibiotic therapy [1,2,[5][6][7][8][9][10][11]. Thus, prompt identification of candidemia is desired but not currently successful, because clinical symptoms are aspecific and the standard technique used to confirm suspected cases is blood culture, which lacks of analytical sensitivity (approximately 50%) [2,[11][12][13].…”

“…Candidemia is primarily caused by Candida albicans but nonalbicans species are increasingly common and clinically relevant [1][2][3][4]8,15,[19][20][21]. There are more than 20 known Candida species, each with different antibiotic susceptibility profiles [1,[15][16][17]1,20,22,23]; therefore, effective treatment depends on the pathogen [14,18,20].…”