What is the role of empirical treatment for suspected invasive candidiasis in non-neutropenic non transplanted patients in the intensive care unit?—Empiricus strikes back!

Bretonnière, Cédric; Lakhal, Karim; Lepoivre, Thierry; Boutoille, David; Morio, Florent

doi:10.21037/jtd.2016.12.99

Cited by 3 publications

(3 citation statements)

References 29 publications

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“…Surveillance cultures are crucial, since a minimum contact period of 4 h with an infected patient or a contaminated surface may be enough for the acquisition of C. auris 4 . Furthermore, colonisation with Candida species is a well‐known risk factor for developing invasive candidiasis 6 and empirical antifungal therapy should be considered whether this is suspected 7 …”

Section: Introductionmentioning

confidence: 99%

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Validation and implementation of a commercial real‐time PCR assay for direct detection of Candida auris from surveillance samples

García

Palop

Cardona

2021

Mycoses

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Background Rapid and reliable laboratory methods are required for detecting the nosocomial yeast Candida auris. AurisID® (Olm Diagnostics) is a real‐time PCR assay approved for detecting C. auris in fungal cultures and directly from blood samples, involving a nucleic acid extraction as a prior step. Objectives The purpose of this study is to validate the AurisID® kit for direct detection of C. auris from surveillance samples without prior DNA extraction and to analyse the results of implementing this methodology to our daily laboratory routine protocol for C. auris surveillance studies. Methods Our PCR method using the AurisID® kit was compared with our routine protocol, consisting of culture in CHROMagar® Candida and identification by mass spectrometry. A total of 113 swabs were used for validation and 136 pair of surveillance samples were tested. Limit of detection (LOD) was determined by using swabs in Amies transport medium, which were spiked in a series of dilutions of a C. auris standardised suspension (0.5 McFarland). Results The PCR method showed high sensitivity, specificity, predictive positive value and predictive negative value (96.6%, 100%, 100% and 98.2%, respectively) when compared with the routine protocol. LOD was 500 CFU/ml, which corresponds to approximately 1 CFU/PCR. Conclusions Our PCR method using the AurisID® kit allows a reduction in the turnaround time for surveillance of C. auris compared with other methods. These results are expected to contribute to control C. auris outbreaks, allowing isolation of patients and cleaning of environmental surfaces in advance.

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Section: Introductionmentioning

confidence: 99%

“…4 Furthermore, colonisation with Candida species is a well-known risk factor for developing invasive candidiasis 6 and empirical antifungal therapy should be considered whether this is suspected. 7 Reliable and rapid laboratory methods for the detection of C. auris, both in clinical and surveillance samples, are also essential.…”

mentioning

confidence: 99%

Validation and implementation of a commercial real‐time PCR assay for direct detection of Candida auris from surveillance samples

García

Palop

Cardona

2021

Mycoses

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“…documented. [42][43][44] From the data in Figure 2, a reduction in the consumption of caspofungin was observed over the period, with an increase in the consumption of micafungin. Although there are differences in terms of in vitro antifungal activities, toxicity profile and pharmacokinetics, the relevance of these distinctions between drugs is minimal.…”

Section: Resultsmentioning

confidence: 99%

Antifungal consumption trends in the adult intensive care unit of a university hospital in Bahia, Brazil

Santos,

Oliveira,

Santos

et al. 2024

OLEL

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Systemic fungal infections represent an emerging problem in current clinical practice, requiring studies on the use of antifungals (ATF). This study aims to analyze ATF consumption trends in an Intensive Care Unit (ICU) for adults at a University Hospital (UH) in Bahia, Brazil. Descriptive and retrospective study, based on consumption records of systemic ATF standardized DDD)/100 patient-days (PD) was proposed. Oscillations in global consumption were observed with a total average of 33.30 DDD/100 PD. There was a reduction in the number of PD treated in the ICU in the first years of the study (2009-2014), followed by an increase of 89.25% between 2014 and 2016, remaining constant in the period from 2016 to 2020. The most consumed ATF, in descending order, were: Fluconazole (57.92%), Amphotericin B Lipid Complex (12.19%), Liposomal Amphotericin B (7.83%), Caspofungin (6.30%) and Amphotericin B Deoxycholate (6.03%). The general variation in drug consumption was 38%, with an increasing trend (p=0.45). Echinocandins showed a growth variation of 591% during the period of this study. Micafungin showed an increasing consumption trend and varied by 98.69% (p=0.001), while caspofungin showed a reduction of 47.77% (p=0.027). The growing trends in ATF consumption in this unit demonstrate the need for monitoring and promoting the rational use of these drugs. Inadequate and/or excessive use, in addition to burdening the healthcare system by increasing costs, can increase the resistance of fungi to the only agents available to combat fungal infections.

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Effect of empirical antifungal treatment on mortality in non-neutropenic critically ill patients: a propensity-matched retrospective cohort study

Tang

Jiang

et al. 2022

Eur J Clin Microbiol Infect Dis

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What is the role of empirical treatment for suspected invasive candidiasis in non-neutropenic non transplanted patients in the intensive care unit?—Empiricus strikes back!

Cited by 3 publications

References 29 publications

Validation and implementation of a commercial real‐time PCR assay for direct detection of Candida auris from surveillance samples

Validation and implementation of a commercial real‐time PCR assay for direct detection of Candida auris from surveillance samples

Antifungal consumption trends in the adult intensive care unit of a university hospital in Bahia, Brazil

Effect of empirical antifungal treatment on mortality in non-neutropenic critically ill patients: a propensity-matched retrospective cohort study

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