Risk Factors for Intra-Abdominal Candidiasis in Intensive Care Units: Results from EUCANDICU Study

Bassetti, Matteo; Vena, Antonio; Giacobbe, Daniele Roberto; Trucchi, Cecilia; Ansaldi, Filippo; Antonelli, Massimo; Adámková, Václava; Alicino, Cristiano; Almyroudi, Maria Panagiota; Atchade, Enora; Azzini, Anna Maria; Brugnaro, Pierluigi; Carannante, Novella; Peghin, Maddalena; Berruti, Marco; Carnelutti, Alessia; Castaldo, Nadia; Corcione, Silvia; Cortegiani, Andrea; Dimοpoulos, George; Dubler, Simon; García-Garmendia, José Luis; Girardis, Massimo; Cornely, Oliver A.; Ianniruberto, Stefano; Kullberg, Bart Jan; Lagrou, Katrien; Lebihan, C.; Luzzati, Roberto; Malbrain, Manu L. N. G.; Merelli, Maria; Marques, Ana; Martín‐Loeches, Ignacio; Mesini, Alessio; Paiva, José-Artur; Raineri, Santi Maurizio; Rautemaa‐Richardson, Riina; Schouten, Jeroen; Spapen, Herbert; Tasioudis, Polychronis; Timsit, Jean‐François; Tisa, Valentino; Tumbarello, Mario; Berg, CP; Veber, Benoît; Venditti, Mario; Voiriot, Guillaume; Wauters, Joost; Zappella, Nathalie; Montravers, Philippe

doi:10.1007/s40121-021-00585-6

Cited by 21 publications

(15 citation statements)

References 49 publications

(72 reference statements)

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“…Notably, while C. albicans has long been known as the predominant Candida species, the patient's cultures also returned positive for C. dubliniensis, a species with a unique affinity for HIV patients [4]. Also significant was the presence of some of the described risk factors for IAC, specifically a prolonged course of antifungal and antibacterial therapy as well as the presence of abdominal drainage [2]. It is our opinion that the patient had additional, and as of yet uninvestigated, factors that may have presented an increased predisposition for IAC; among these were type 2 diabetes mellitus with severe hyperglycemia, constipation, underlying abdominal/gastrointestinal pathology in the form of an incarcerated hernia, and acute kidney injury.…”

Section: Discussionmentioning

confidence: 95%

“…While IAC shares many of the conventional risk factors with its bloodstream-focused cousin, epidemiology, scope of variance in clinical presentations, and precise delineation of disease parameters continue to elude further characterization and understanding [1]. Prior investigations have identified repeated perforations of the gastrointestinal system, leakage of anastomoses, abdominal drain, and courses of antifungal or antibiotic therapy lasting longer than a week as likely risk factors for IAC, especially in the critically ill [2]. Additional risk factors are likely to be identified as studies into deep-seated candidiasis and IAC progress.…”

Section: Discussionmentioning

confidence: 99%

“…Candida species can be found with patients who are high risk like those who are immunocompromised, have a prolonged hospital stay, or have recurrent infections [6]. Post-surgical patients are at higher risk for these fungal infections [2]. Like in this patient, fluconazole or micafungin are often used to treat Candida infections.…”

Section: Introductionmentioning

confidence: 99%

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Intra-abdominal abscess with Candida in a post-operative setting

Oh¹,

Rodrigues²,

Asllanaj³

et al. 2023

World J. Adv. Res. Rev.

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The goal in this case report is to discuss one presentation of the microbiology of the Candida species in an intra-abdominal abscess which is under reported. In general, the Candida species fungi is a common yeast found human beings as part of the microbiology. Common sites of candidiasis are often the oral cavity or the genitalia. Candida species have been found to have a mutualistic relationship with different species with the body [5]. When overproduction of Candida species occurs, it can cause pathological infections in patients. While it is common to see patients with Candida species in their gut micro biome, it is not well documented to have intra-abdominal abscesses that grow Candida species. Typically, bacterial causes are first on the differential for clinicians. This case presentation looks to discuss some of presenting factors seen in intra-abdominal candidiasis (IAC) and what leads to it being under diagnosed.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

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Intra-abdominal abscess with Candida in a post-operative setting

Oh¹,

Rodrigues²,

Asllanaj³

et al. 2023

World J. Adv. Res. Rev.

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“…Individual patient characteristics must also be considered, as risk groups differ between IA (patients with COPD, patients who are immunocompromised, patients with viral pneumonia, liver cirrhosis, or autoimmune diseases) and invasive Candida (IC) infections (any patient with disruption of the skin and gastro-intestinal barrier, and those receiving treatments that change the composition of the gut microbiome). [ 16 , 28 – 30 ]…”

Section: Discussionmentioning

confidence: 99%

Exploring European Consensus About the Remaining Treatment Challenges and Subsequent Opportunities to Improve the Management of Invasive Fungal Infection (IFI) in the Intensive Care Unit

Hoenigl,

Enoch,

Wichmann

et al. 2024

Mycopathologia

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Background The global prevalence of invasive fungal infections (IFI) is increasing, particularly within Intensive Care Units (ICU), where Candida spp. and Aspergillus spp. represent the most important pathogens. Diagnosis and management of IFIs becomes progressively challenging, with increasing antifungal resistance and the emergence of rare fungal species. Through a consensus survey focused on assessing current views on how IFI should be managed, the aim of this project was to identify challenges around diagnosing and managing IFIs in the ICU. The current status in different countries and perceived challenges to date amongst a multidisciplinary cohort of healthcare professionals involved in the care of IFI in the ICU was assessed. Methods Using a modified Delphi approach, an expert panel developed 44 Likert-scale statements across 6 key domains concerning patient screening and minimal standards for diagnosis of IFIs in ICU; initiation and termination of antifungal treatments and how to minimise their side effects and insights for future research on this topic. These were used to develop an online survey which was distributed on a convenience sampling basis utilising the subscriber list held by an independent provider (M3 Global). This survey was distributed to intensivists, infectious disease specialists, microbiologists and antimicrobial/ICU pharmacists within the UK, Germany, Spain, France and Italy. The threshold for consensus was set at 75%. Results A total of 335 responses were received during the five-month collection period. From these, 29/44 (66%) statements attained very high agreement (90%), 11/44 (25%) high agreement (< 90% and ≥ 75%), and 4/44 (9%) did not meet threshold for consensus (< 75%). Conclusion The results outline the need for physicians to be aware of the local incidence of IFI and the associated rate of azole resistance in their ICUs. Where high clinical suspicion exists, treatment should start immediately and prior to receiving the results from any diagnostic test. Beta-D-glucan testing should be available to all ICU centres, with results available within 48 h to inform the cessation of empirical antifungal therapy. These consensus statements and proposed measures may guide future areas for further research to optimise the management of IFIs in the ICU.

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“…IC can be divided into two non-mutually exclusive forms: ( i ) candidemia; ( ii ) deep-seated candidiasis. The most common form of deep-seated candidiasis in non-neutropenic, critically ill patients in the ICU is intra-abdominal candidiasis (IAC) [ 6 , 8 , 31 , 39 ].…”

Section: Introductionmentioning

confidence: 99%

Invasive Fungal Diseases in Adult Patients in Intensive Care Unit (FUNDICU): 2024 consensus definitions from ESGCIP, EFISG, ESICM, ECMM, MSGERC, ISAC, and ISHAM

Bassetti,

Giacobbe,

Agvald-Ohman

et al. 2024

Intensive Care Med

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Purpose The aim of this document was to develop standardized research definitions of invasive fungal diseases (IFD) in non-neutropenic, adult patients without classical host factors for IFD, admitted to intensive care units (ICUs). Methods After a systematic assessment of the diagnostic performance for IFD in the target population of already existing definitions and laboratory tests, consensus definitions were developed by a panel of experts using the RAND/UCLA appropriateness method. Results Standardized research definitions were developed for proven invasive candidiasis, probable deep-seated candidiasis, proven invasive aspergillosis, probable invasive pulmonary aspergillosis, and probable tracheobronchial aspergillosis. The limited evidence on the performance of existing definitions and laboratory tests for the diagnosis of IFD other than candidiasis and aspergillosis precluded the development of dedicated definitions, at least pending further data. The standardized definitions provided in the present document are aimed to speed-up the design, and increase the feasibility, of future comparative research studies. Supplementary Information The online version contains supplementary material available at 10.1007/s00134-024-07341-7.

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Risk Factors for Intra-Abdominal Candidiasis in Intensive Care Units: Results from EUCANDICU Study

Abstract: from the Study Group for Infections in Critically Ill Patients (ESGCIP) of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID)

Cited by 21 publications

References 49 publications

Intra-abdominal abscess with Candida in a post-operative setting

Intra-abdominal abscess with Candida in a post-operative setting

Exploring European Consensus About the Remaining Treatment Challenges and Subsequent Opportunities to Improve the Management of Invasive Fungal Infection (IFI) in the Intensive Care Unit

Invasive Fungal Diseases in Adult Patients in Intensive Care Unit (FUNDICU): 2024 consensus definitions from ESGCIP, EFISG, ESICM, ECMM, MSGERC, ISAC, and ISHAM

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