β-D-glucan Surveillance with Preemptive Anidulafungin for Invasive Candidiasis in Intensive Care Unit Patients: A Randomized Pilot Study

Hanson, Kimberly E.; Pfeiffer, Christopher D.; Lease, Erika D.; Balch, Alfred H.; Zaas, Aimee K.; Perfect, John R.; Alexander, Barbara D.

doi:10.1371/journal.pone.0042282

Cited by 111 publications

(73 citation statements)

References 41 publications

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“…A single-centre study of twice-weekly BDG surveillance among high-risk ICU patients for >3 days reported a positive predictive value (PPV) of 30% for IC (sensitivity 100%, specificity 75%) with a negative predictive value (NPV) of 100%. 26 The study also found pre-emptive anidulafungin to be safe and associated with good outcomes. In light of more contemporary data, a re-evaluation of the role of BDG surveillance in Australia and New Zealand is warranted.…”

Section: ß(13)-d-glucan Detectionmentioning

confidence: 76%

Consensus guidelines for the treatment of yeast infections in the haematology, oncology and intensive care setting, 2014

Chen

Sorrell

Chang

et al. 2014

Internal Medicine Journal

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Pathogenic yeast forms are commonly associated with invasive fungal disease in the immunocompromised host, including patients with haematological malignancies and patients of haemopoietic stem cell transplants. Yeasts include the Candida spp., Cryptococcus spp., Pneumocystis jirovecii and some lesser-known pathogens. Candida species remain the most common cause of invasive yeast infections (and the most common human pathogenic fungi). These guidelines present evidence-based recommendations for the antifungal management of established, invasive yeast infections in adult and paediatric patients in the haematology/oncology setting. Consideration is also given to the critically ill patient in intensive care units, including the neonatal intensive care unit. Evidence for 'preemptive' or 'diagnostic-driven antifungal therapy' is also discussed. For the purposes of this paper, invasive yeast diseases are categorised under the headings of invasive candidiasis, cryptococcosis and uncommon yeast infections. Specific recommendations for the management of Pneumocystis jirovecii are presented in an accompanying article (see consensus guidelines by Cooley et al. appearing elsewhere in this supplement).

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Section: ß(13)-d-glucan Detectionmentioning

confidence: 76%

Consensus guidelines for the treatment of yeast infections in the haematology, oncology and intensive care setting, 2014

Chen

Sorrell

Chang

et al. 2014

Internal Medicine Journal

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“…In the challenging scenario of early diagnosis of IC, recent studies have demonstrated the diagnostic value of BDG and CAGTA [19,[38][39][40][41][42]. Although the use of BDG measurement in daily practice for establishing the indication or the withdrawal of ESAT should be defined, recent observational studies [41,42] showed that negativity of the BDG assay may be used as a strategy to discontinue ESAT because of the high sensitivity and negative predictive value of the test.…”

Section: Invasive Candidiasismentioning

confidence: 99%

Intensive care medicine research agenda on invasive fungal infection in critically ill patients

et al. 2017

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Purpose:To describe concisely the current standards of care, major recent advances, common beliefs that have been contradicted by recent trials, areas of uncertainty, and clinical studies that need to be performed over the next decade and their expected outcomes with regard to Candida and Aspergillus infections in non-neutropenic patients in the ICU setting. Methods:A systematic review of the medical literature taking account of national and international guidelines and expert opinion. Results:Severe invasive fungal infections (IFIs) are becoming increasingly frequent in critically ill patients. Approximately 80% of IFIs are due to Candida spp. and 0.3-19% to Aspergillus spp. Recent observations emphasize the necessity of building a worldwide sentinel network to monitor the emergence of new fungal species and changes in susceptibility. Robust data on the attributable mortality are essential for the design of clinical studies with mortality endpoints. Although early antifungal therapy for Candida has been recommended in patients with risk factors, sepsis of unknown cause, and positive Candida serum biomarkers [β-1 → 3-d-glucan (BDG) and Candida albicans germ tube antibody (CAGTA)], its usefulness and influence on outcome need to be confirmed. Future studies may specifically address the optimal diagnostic and therapeutic strategies for patients with abdominal candidiasis. Better knowledge of the pharmacokinetics of antifungal molecules and tissue penetration is a key issue for intensivists. Regarding invasive aspergillosis, further investigation is needed to determine its incidence in the ICU, its relationship with influenza outbreaks, the clinical impact of rapid diagnosis, and the significance of combination treatment. Conclusions:Fundamental questions regarding IFI have to be addressed over the next decade. The clinical studies described in this research agenda should provide a template and set priorities for the clinical investigations that need to be performed.

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“…Preemptive ANF was nontoxic and often successfully tolerated with exceptional results. BG surveillance may be effectul in diagnosing ICU patients with a greater probability of developing IM [53].…”

Section: Advance Therapies For Better Treatment Strategies and Need Fmentioning

confidence: 99%

Echinocandins Versus Dated Antifungals in Combination Against Opportunistic Mycotic Infections

Narwal¹,

Balhara²,

Chaudhary³

et al. 2017

Asian J Pharm Clin Res

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Scientific and clinical reports globally demonstrated that the opportunistic mycotic infections are at major risk to the human fitness. In the past few decades, the development of resistance in microbes to existing antifungals has emphasized on the search of new antimycotic drugs. As a matter of fact, "echinocandins" are new categories of broad-spectrum antifungal enlighten a hope in this direction. Echinocandins are bulky lipopeptides that inhibit the production of β-[1,3]-glucan "a major constituent of fungal cell wall" which ultimately leads to the death of fungal pathogens. In vitro as well as in vivo published reports have demonstrated that the echinocandins exhibit fungicidal activity against most Candida spp., while fungistatic against Aspergillus spp. and exclusively found to be more effective when tested in combination with polyenes/azoles. The present article is expert views on the recent and historical literature available on the antifungal therapies with accessing their impact on the human health. Emphasis is given to the utility of the echinocandins a potental antifungal agent by discussing recent examples of clinical and laboratory studies including the use of improved proteomics approaches to know a bit more about the interaction of human host and fungal pathogens.

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β-D-glucan Surveillance with Preemptive Anidulafungin for Invasive Candidiasis in Intensive Care Unit Patients: A Randomized Pilot Study

Cited by 111 publications

References 41 publications

Consensus guidelines for the treatment of yeast infections in the haematology, oncology and intensive care setting, 2014

Consensus guidelines for the treatment of yeast infections in the haematology, oncology and intensive care setting, 2014

Intensive care medicine research agenda on invasive fungal infection in critically ill patients

Echinocandins Versus Dated Antifungals in Combination Against Opportunistic Mycotic Infections

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