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Semin Respir Crit Care Med 2011; 32(2): 159-173
DOI: 10.1055/s-0031-1275528
© Thieme Medical Publishers

Candida Prophylaxis and Therapy in the ICU

Pablo M. Echeverria1 , Daniel H. Kett1 , Elie Azoulay2 , 3
  • 1Division of Pulmonary and Critical Care Medicine, The Miller School of Medicine at the University of Miami, Miami, Florida
  • 2AP-HP, Hôpital Saint-Louis, Medical ICU, Paris, France
  • 3University Paris-7, UFR de Médecine, Paris, France
Further Information

Publication History

Publication Date:
19 April 2011 (online)

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ABSTRACT

The incidence of invasive candidiasis in critically ill patients has increased over the past decade and is associated with considerable morbidity and mortality. Candida is identified in up to 17% of ICU patients, with candidemia occurring in ∼1%. Candida albicans continues to account for approximately half of the invasive candidiasis cases, with non-albicans Candida species, such Candida glabrata, increasing in frequency. Diagnosis of invasive candidiasis is commonly based on blood culture results; however, the sensitivity of blood culture to identify Candida is low. Because early, appropriate therapy has been associated with improved outcomes, antifungal therapy is being implemented in critically ill patients with risk factors for candidemia (prophylaxis). Systemic antifungal therapy is also being utilized in patients at increased risk for invasive candidiasis based on surrogate markers of infection such as colonization (preemptive therapy), or in patients with unresolving sepsis despite appropriate management (empirical therapy). Recent guidelines on the use of antifungal therapy have better identified patients who can be treated with azole derivatives and those who may benefit from echinocandins or polyenes. However, prospective trials are still needed to better identify appropriate therapy for patients at risk for, or with, confirmed invasive Candida infections.

KEYWORDS

Candida - ICU - colonization - outcomes - echinocandins

REFERENCES

  • 1 Wisplinghoff H, Bischoff T, Tallent S M, Seifert H, Wenzel R P, Edmond M B. Nosocomial bloodstream infections in US hospitals: analysis of 24,179 cases from a prospective nationwide surveillance study.  Clin Infect Dis. 2004;  39 (3) 309-317
    CrossrefPubMedGoogle Scholar
  • 2 Horn D L, Fishman J A, Steinbach W J et al.. Presentation of the PATH Alliance registry for prospective data collection and analysis of the epidemiology, therapy, and outcomes of invasive fungal infections.  Diagn Microbiol Infect Dis. 2007;  59 (4) 407-414
    CrossrefPubMedGoogle Scholar
  • 3 Richardson M D. Changing patterns and trends in systemic fungal infections.  J Antimicrob Chemother. 2005;  56 (Suppl 1) i5-i11
    CrossrefPubMedGoogle Scholar
  • 4 Lipsett P A. Surgical critical care: fungal infections in surgical patients.  Crit Care Med. 2006;  34 (9, Suppl) S215-S224
    CrossrefPubMedGoogle Scholar
  • 5 Eggimann P, Garbino J, Pittet D. Epidemiology of Candida species infections in critically ill non-immunosuppressed patients.  Lancet Infect Dis. 2003;  3 (11) 685-702
    CrossrefPubMedGoogle Scholar
  • 6 Kullberg B J, Oude Lashof A M. Epidemiology of opportunistic invasive mycoses.  Eur J Med Res. 2002;  7 (5) 183-191
    PubMedGoogle Scholar
  • 7 Garbino J, Kolarova L, Rohner P, Lew D, Pichna P, Pittet D. Secular trends of candidemia over 12 years in adult patients at a tertiary care hospital.  Medicine (Baltimore). 2002;  81 (6) 425-433
    CrossrefPubMedGoogle Scholar
  • 8 Pfaller M A, Diekema D J. Epidemiology of invasive candidiasis: a persistent public health problem.  Clin Microbiol Rev. 2007;  20 (1) 133-163
    CrossrefPubMedGoogle Scholar
  • 9 Tortorano A M, Peman J, Bernhardt H ECMM Working Group on Candidaemia et al. Epidemiology of candidaemia in Europe: results of 28-month European Confederation of Medical Mycology (ECMM) hospital-based surveillance study.  Eur J Clin Microbiol Infect Dis. 2004;  23 (4) 317-322
    CrossrefPubMedGoogle Scholar
  • 10 Arendrup M C, Fuursted K, Gahrn-Hansen B et al.. Semi-national surveillance of fungaemia in Denmark 2004-2006: increasing incidence of fungaemia and numbers of isolates with reduced azole susceptibility.  Clin Microbiol Infect. 2008;  14 (5) 487-494
    CrossrefPubMedGoogle Scholar
  • 11 Arendrup M C, Fuursted K, Gahrn-Hansen B et al.. Seminational surveillance of fungemia in Denmark: notably high rates of fungemia and numbers of isolates with reduced azole susceptibility.  J Clin Microbiol. 2005;  43 (9) 4434-4440
    CrossrefPubMedGoogle Scholar
  • 12 Poikonen E, Lyytikäinen O, Anttila V J, Ruutu P. Candidemia in Finland, 1995-1999.  Emerg Infect Dis. 2003;  9 (8) 985-990
    PubMedGoogle Scholar
  • 13 Chen S, Slavin M, Nguyen Q Australian Candidemia Study et al. Active surveillance for candidemia, Australia.  Emerg Infect Dis. 2006;  12 (10) 1508-1516
    CrossrefPubMedGoogle Scholar
  • 14 Hsueh P R, Teng L J, Yang P C, Ho S W, Luh K T. Emergence of nosocomial candidemia at a teaching hospital in Taiwan from 1981 to 2000: increased susceptibility of Candida species to fluconazole.  Microb Drug Resist. 2002;  8 (4) 311-319
    CrossrefPubMedGoogle Scholar
  • 15 Cao B, Wang H, Wu L, Sun W J, Li F, Liu Y M. Epidemiological study of invasive nosocomial candidiasis in 2 teaching hospitals in Beijing [in Chinese].  Zhonghua Yi Xue Za Zhi. 2008;  88 (28) 1970-1973
    PubMedGoogle Scholar
  • 16 Almirante B, Rodríguez D, Park B J Barcelona Candidemia Project Study Group et al. Epidemiology and predictors of mortality in cases of Candida bloodstream infection: results from population-based surveillance, Barcelona, Spain, from 2002 to 2003.  J Clin Microbiol. 2005;  43 (4) 1829-1835
    CrossrefPubMedGoogle Scholar
  • 17 Gudlaugsson O, Gillespie S, Lee K et al.. Attributable mortality of nosocomial candidemia, revisited.  Clin Infect Dis. 2003;  37 (9) 1172-1177
    CrossrefPubMedGoogle Scholar
  • 18 Morgan J, Meltzer M I, Plikaytis B D et al.. Excess mortality, hospital stay, and cost due to candidemia: a case-control study using data from population-based candidemia surveillance.  Infect Control Hosp Epidemiol. 2005;  26 (6) 540-547
    CrossrefPubMedGoogle Scholar
  • 19 Zaoutis T E, Argon J, Chu J, Berlin J A, Walsh T J, Feudtner C. The epidemiology and attributable outcomes of candidemia in adults and children hospitalized in the United States: a propensity analysis.  Clin Infect Dis. 2005;  41 (9) 1232-1239
    CrossrefPubMedGoogle Scholar
  • 20 Falagas M E, Apostolou K E, Pappas V D. Attributable mortality of candidemia: a systematic review of matched cohort and case-control studies.  Eur J Clin Microbiol Infect Dis. 2006;  25 (7) 419-425
    CrossrefPubMedGoogle Scholar
  • 21 Leleu G, Aegerter P, Guidet B. Collège des Utilisateurs de Base de Données en Réanimation . Systemic candidiasis in intensive care units: a multicenter, matched-cohort study.  J Crit Care. 2002;  17 (3) 168-175
    CrossrefPubMedGoogle Scholar
  • 22 Rentz A M, Halpern M T, Bowden R. The impact of candidemia on length of hospital stay, outcome, and overall cost of illness.  Clin Infect Dis. 1998;  27 (4) 781-788
    CrossrefPubMedGoogle Scholar
  • 23 Pelz R K, Lipsett P A, Swoboda S M et al.. Candida infections: outcome and attributable ICU costs in critically ill patients.  J Intensive Care Med. 2000;  15 255-261
    CrossrefPubMedGoogle Scholar
  • 24 Wilson L S, Reyes C M, Stolpman M, Speckman J, Allen K, Beney J. The direct cost and incidence of systemic fungal infections.  Value Health. 2002;  5 (1) 26-34
    CrossrefPubMedGoogle Scholar
  • 25 Wey S B, Mori M, Pfaller M A, Woolson R F, Wenzel R P. Hospital-acquired candidemia: the attributable mortality and excess length of stay.  Arch Intern Med. 1988;  148 (12) 2642-2645
    CrossrefPubMedGoogle Scholar
  • 26 Olaechea P M, Palomar M, León-Gil C EPCAN Study Group et al. Economic impact of Candida colonization and Candida infection in the critically ill patient.  Eur J Clin Microbiol Infect Dis. 2004;  23 (4) 323-330
    CrossrefPubMedGoogle Scholar
  • 27 Moran C, Grussemeyer C A, Spalding J R, Benjamin Jr D K, Reed S D. Comparison of costs, length of stay, and mortality associated with Candida glabrata and Candida albicans bloodstream infections.  Am J Infect Control. 2010;  38 (1) 78-80
    CrossrefPubMedGoogle Scholar
  • 28 Hassan I, Powell G, Sidhu M, Hart W M, Denning D W. Excess mortality, length of stay and cost attributable to candidaemia.  J Infect. 2009;  59 (5) 360-365
    CrossrefPubMedGoogle Scholar
  • 29 Hajjeh R A, Sofair A N, Harrison L H et al.. Incidence of bloodstream infections due to Candida species and in vitro susceptibilities of isolates collected from 1998 to 2000 in a population-based active surveillance program.  J Clin Microbiol. 2004;  42 (4) 1519-1527
    CrossrefPubMedGoogle Scholar
  • 30 Yap H Y, Kwok K M, Gomersall C D et al.. Epidemiology and outcome of Candida bloodstream infection in an intensive care unit in Hong Kong.  Hong Kong Med J. 2009;  15 (4) 255-261
    PubMedGoogle Scholar
  • 31 Voss A, le Noble J L, Verduyn Lunel F M, Foudraine N A, Meis J F. Candidemia in intensive care unit patients: risk factors for mortality.  Infection. 1997;  25 (1) 8-11
    CrossrefPubMedGoogle Scholar
  • 32 Nolla-Salas J, Sitges-Serra A, León-Gil C Study Group of Fungal Infection in the ICU et al. Candidemia in non-neutropenic critically ill patients: analysis of prognostic factors and assessment of systemic antifungal therapy.  Intensive Care Med. 1997;  23 (1) 23-30
    CrossrefPubMedGoogle Scholar
  • 33 Kett D H, Azoulay E, Echeverria P M, Vincent J L, Investigators E I. Candida bloodstream infections in the intensive care units: analysis of the Extended Prevalence of Infection in an Intensive Care Unit Study.  Crit Care Med. 2011;  39 665-670
    CrossrefPubMedGoogle Scholar
  • 34 Aliyu S H, Enoch D A, Abubakar I I et al.. Candidaemia in a large teaching hospital: a clinical audit.  QJM. 2006;  99 (10) 655-663
    CrossrefPubMedGoogle Scholar
  • 35 Bassetti M, Righi E, Costa A et al.. Epidemiological trends in nosocomial candidemia in intensive care.  BMC Infect Dis. 2006;  6 21
    CrossrefPubMedGoogle Scholar
  • 36 Kibbler C C, Seaton S, Barnes R A et al.. Management and outcome of bloodstream infections due to Candida species in England and Wales.  J Hosp Infect. 2003;  54 (1) 18-24
    CrossrefPubMedGoogle Scholar
  • 37 Comert F, Kulah C, Aktas E, Eroglu O, Ozlu N. Identification of Candida species isolated from patients in intensive care unit and in vitro susceptibility to fluconazole for a 3-year period.  Mycoses. 2007;  50 (1) 52-57
    CrossrefPubMedGoogle Scholar
  • 38 Pfaller M A, Messer S A, Hollis R J et al.. Variation in susceptibility of bloodstream isolates of Candida glabrata to fluconazole according to patient age and geographic location in the United States in 2001 to 2007.  J Clin Microbiol. 2009;  47 (10) 3185-3190
    CrossrefPubMedGoogle Scholar
  • 39 Leroy O, Gangneux J P, Montravers P AmarCand Study Group et al. Epidemiology, management, and risk factors for death of invasive Candida infections in critical care: a multicenter, prospective, observational study in France (2005-2006).  Crit Care Med. 2009;  37 (5) 1612-1618
    CrossrefPubMedGoogle Scholar
  • 40 Laverdiere M, Labbé A C, Restieri C et al.. Susceptibility patterns of Candida species recovered from Canadian intensive care units.  J Crit Care. 2007;  22 (3) 245-250
    CrossrefPubMedGoogle Scholar
  • 41 Marriott D JE, Playford E G, Chen S Australian Candidaemia Study et al. Determinants of mortality in non-neutropenic ICU patients with candidaemia.  Crit Care. 2009;  13 (4) R115
    PubMedGoogle Scholar
  • 42 Yin Q Q, Zhang Y T, Fang Q. Study on the morbidity and pathogens of patients with candidemia at the intensive care unit [in Chinese].  Zhonghua Liu Xing Bing Xue Za Zhi. 2008;  29 (5) 464-468
    PubMedGoogle Scholar
  • 43 Pfaller M A, Boyken L, Hollis R J et al.. In vitro susceptibility of invasive isolates of Candida spp. to anidulafungin, caspofungin, and micafungin: six years of global surveillance.  [Erratum in J Clin Microbiol 2008 Sep;46(9):3184–3185] J Clin Microbiol. 2008;  46 (1) 150-156
    CrossrefPubMedGoogle Scholar
  • 44 Colombo A L, Perfect J, DiNubile M et al.. Global distribution and outcomes for Candida species causing invasive candidiasis: results from an international randomized double-blind study of caspofungin versus amphotericin B for the treatment of invasive candidiasis.  Eur J Clin Microbiol Infect Dis. 2003;  22 (8) 470-474
    CrossrefPubMedGoogle Scholar
  • 45 Pappas P G, Rex J H, Lee J NIAID Mycoses Study Group et al. A prospective observational study of candidemia: epidemiology, therapy, and influences on mortality in hospitalized adult and pediatric patients.  Clin Infect Dis. 2003;  37 (5) 634-643
    CrossrefPubMedGoogle Scholar
  • 46 Bedini A, Venturelli C, Mussini C et al.. Epidemiology of candidaemia and antifungal susceptibility patterns in an Italian tertiary-care hospital.  Clin Microbiol Infect. 2006;  12 (1) 75-80
    CrossrefPubMedGoogle Scholar
  • 47 Davis S L, Vazquez J A, McKinnon P S. Epidemiology, risk factors, and outcomes of Candida albicans versus non-albicans candidemia in nonneutropenic patients.  Ann Pharmacother. 2007;  41 (4) 568-573
    CrossrefPubMedGoogle Scholar
  • 48 Cohen Y, Karoubi P, Adrie C et al.. Early prediction of Candida glabrata fungemia in nonneutropenic critically ill patients.  Crit Care Med. 2010;  38 (3) 826-830
    CrossrefPubMedGoogle Scholar
  • 49 Vincent J-L, Rello J, Marshall J EPIC II Group of Investigators et al. International study of the prevalence and outcomes of infection in intensive care units.  JAMA. 2009;  302 (21) 2323-2329
    CrossrefPubMedGoogle Scholar
  • 50 Choi H K, Jeong S J, Lee H S et al.. Bloodstream infections by Candida glabrata and Candida krusei: a single-center experience.  Korean J Intern Med. 2009;  24 (3) 263-269
    CrossrefPubMedGoogle Scholar
  • 51 Hadley S, Lee W W, Ruthazer R, Nasraway Jr S A. Candidemia as a cause of septic shock and multiple organ failure in nonimmunocompromised patients.  Crit Care Med. 2002;  30 (8) 1808-1814
    CrossrefPubMedGoogle Scholar
  • 52 Garrouste-Orgeas M, Timsit J F, Tafflet M OUTCOMEREA Study Group et al. Excess risk of death from intensive care unit-acquired nosocomial bloodstream infections: a reappraisal.  Clin Infect Dis. 2006;  42 (8) 1118-1126
    CrossrefPubMedGoogle Scholar
  • 53 Morrell M, Fraser V J, Kollef M H. Delaying the empiric treatment of Candida bloodstream infection until positive blood culture results are obtained: a potential risk factor for hospital mortality.  Antimicrob Agents Chemother. 2005;  49 (9) 3640-3645
    CrossrefPubMedGoogle Scholar
  • 54 Garey K W, Rege M, Pai M P et al.. Time to initiation of fluconazole therapy impacts mortality in patients with candidemia: a multi-institutional study.  Clin Infect Dis. 2006;  43 (1) 25-31
    CrossrefPubMedGoogle Scholar
  • 55 Puzniak L, Teutsch S, Powderly W, Polish L. Has the epidemiology of nosocomial candidemia changed?.  Infect Control Hosp Epidemiol. 2004;  25 (8) 628-633
    CrossrefPubMedGoogle Scholar
  • 56 Guery B P, Arendrup M C, Auzinger G et al.. Management of invasive candidiasis and candidemia in adult non-neutropenic intensive care unit patients, I: Epidemiology and diagnosis.  Intensive Care Med. 2009;  35 (1) 55-62
    CrossrefPubMedGoogle Scholar
  • 57 Vincent J L, Anaissie E, Bruining H et al.. Epidemiology, diagnosis and treatment of systemic Candida infection in surgical patients under intensive care.  Intensive Care Med. 1998;  24 (3) 206-216
    CrossrefPubMedGoogle Scholar
  • 58 Rex J H, Sobel J D. Prophylactic antifungal therapy in the intensive care unit.  Clin Infect Dis. 2001;  32 (8) 1191-1200
    CrossrefPubMedGoogle Scholar
  • 59 Blumberg H M, Jarvis W R, Soucie J M National Epidemiology of Mycoses Survey(NEMIS) Study Group et al. Risk factors for candidal bloodstream infections in surgical intensive care unit patients: the NEMIS prospective multicenter study.  Clin Infect Dis. 2001;  33 (2) 177-186
    CrossrefPubMedGoogle Scholar
  • 60 Sobel J D, Rex J H. Invasive candidiasis: turning risk into a practical prevention policy?.  Clin Infect Dis. 2001;  33 (2) 187-190
    CrossrefPubMedGoogle Scholar
  • 61 Agvald-Ohman C, Klingspor L, Hjelmqvist H, Edlund C. Invasive candidiasis in long-term patients at a multidisciplinary intensive care unit: Candida colonization index, risk factors, treatment and outcome.  Scand J Infect Dis. 2008;  40 (2) 145-153
    CrossrefPubMedGoogle Scholar
  • 62 León C, Ruiz-Santana S, Saavedra P EPCAN Study Group et al. A bedside scoring system (“Candida score”) for early antifungal treatment in nonneutropenic critically ill patients with Candida colonization.  Crit Care Med. 2006;  34 (3) 730-737
    CrossrefPubMedGoogle Scholar
  • 63 León C, Ruiz-Santana S, Saavedra P Cava Study Group et al. Usefulness of the “Candida score” for discriminating between Candida colonization and invasive candidiasis in non-neutropenic critically ill patients: a prospective multicenter study.  Crit Care Med. 2009;  37 (5) 1624-1633
    CrossrefPubMedGoogle Scholar
  • 64 Dupont H, Paugam-Burtz C, Muller-Serieys C et al.. Predictive factors of mortality due to polymicrobial peritonitis with Candida isolation in peritoneal fluid in critically ill patients.  Arch Surg. 2002;  137 (12) 1341-1346 discussion 1347
    CrossrefPubMedGoogle Scholar
  • 65 Pelz R K, Lipsett P A, Swoboda S M, Diener-West M, Hammond J M, Hendrix C W. The diagnostic value of fungal surveillance cultures in critically ill patients.  Surg Infect (Larchmt). 2000;  1 (4) 273-281
    CrossrefPubMedGoogle Scholar
  • 66 Michalopoulos A S, Geroulanos S, Mentzelopoulos S D. Determinants of candidemia and candidemia-related death in cardiothoracic ICU patients.  Chest. 2003;  124 (6) 2244-2255
    CrossrefPubMedGoogle Scholar
  • 67 Ostrosky-Zeichner L, Pappas P G, Shoham S et al.. Improvement of a clinical prediction rule for clinical trials on prophylaxis for invasive candidiasis in the intensive care unit.  Mycoses. 2011;  54 (1) 46-51
    CrossrefPubMedGoogle Scholar
  • 68 Pittet D, Monod M, Suter P M, Frenk E, Auckenthaler R. Candida colonization and subsequent infections in critically ill surgical patients.  Ann Surg. 1994;  220 (6) 751-758
    CrossrefPubMedGoogle Scholar
  • 69 Pelz R K, Hendrix C W, Swoboda S M et al.. Double-blind placebo-controlled trial of fluconazole to prevent candidal infections in critically ill surgical patients.  Ann Surg. 2001;  233 (4) 542-548
    CrossrefPubMedGoogle Scholar
  • 70 Ostrosky-Zeichner L, Pappas P G. Invasive candidiasis in the intensive care unit.  Crit Care Med. 2006;  34 (3) 857-863
    CrossrefPubMedGoogle Scholar
  • 71 Azoulay E, Timsit J F, Tafflet M Outcomerea Study Group et al. Candida colonization of the respiratory tract and subsequent Pseudomonas ventilator-associated pneumonia.  Chest. 2006;  129 (1) 110-117
    CrossrefPubMedGoogle Scholar
  • 72 Delisle M S, Williamson D R, Perreault M M, Albert M, Jiang X, Heyland D K. The clinical significance of Candida colonization of respiratory tract secretions in critically ill patients.  J Crit Care. 2008;  23 (1) 11-17
    CrossrefPubMedGoogle Scholar
  • 73 Canadian Critical Care Trials Group . A randomized trial of diagnostic techniques for ventilator-associated pneumonia.  N Engl J Med. 2006;  355 (25) 2619-2630
    CrossrefPubMedGoogle Scholar
  • 74 Petri M G, König J, Moecke H P et al.. Epidemiology of invasive mycosis in ICU patients: a prospective multicenter study in 435 non-neutropenic patients. Paul-Ehrlich Society for Chemotherapy, Divisions of Mycology and Pneumonia Research.  Intensive Care Med. 1997;  23 (3) 317-325
    CrossrefPubMedGoogle Scholar
  • 75 Charles P E, Dalle F, Aube H et al.. Candida spp. colonization significance in critically ill medical patients: a prospective study.  Intensive Care Med. 2005;  31 (3) 393-400
    CrossrefPubMedGoogle Scholar
  • 76 Piarroux R, Grenouillet F, Balvay P et al.. Assessment of preemptive treatment to prevent severe candidiasis in critically ill surgical patients.  Crit Care Med. 2004;  32 (12) 2443-2449
    CrossrefPubMedGoogle Scholar
  • 77 Fricker-Hidalgo H, Lebeau B, Pelloux H, Grillot R. Use of the BACTEC 9240 System with Mycosis-IC/F blood culture bottles for detection of fungemia.  J Clin Microbiol. 2004;  42 (4) 1855-1856, author reply 1855–1856
    CrossrefPubMedGoogle Scholar
  • 78 Gherna M, Merz W G. Identification of Candida albicans and Candida glabrata within 1.5 hours directly from positive blood culture bottles with a shortened peptide nucleic acid fluorescence in situ hybridization protocol.  J Clin Microbiol. 2009;  47 (1) 247-248
    CrossrefPubMedGoogle Scholar
  • 79 Shepard J R, Addison R M, Alexander B D et al.. Multicenter evaluation of the Candida albicans/Candida glabrata peptide nucleic acid fluorescent in situ hybridization method for simultaneous dual-color identification of C. albicans and C. glabrata directly from blood culture bottles.  J Clin Microbiol. 2008;  46 (1) 50-55
    CrossrefPubMedGoogle Scholar
  • 80 Ostrosky-Zeichner L, Alexander B D, Kett D H et al.. Multicenter clinical evaluation of the (1—> 3) beta-D-glucan assay as an aid to diagnosis of fungal infections in humans.  Clin Infect Dis. 2005;  41 (5) 654-659
    CrossrefPubMedGoogle Scholar
  • 81 Obayashi T, Negishi K, Suzuki T, Funata N. Reappraisal of the serum (1—> 3)-beta-D-glucan assay for the diagnosis of invasive fungal infections—a study based on autopsy cases from 6 years.  Clin Infect Dis. 2008;  46 (12) 1864-1870
    CrossrefPubMedGoogle Scholar
  • 82 Odabasi Z, Mattiuzzi G, Estey E et al.. Beta-D-glucan as a diagnostic adjunct for invasive fungal infections: validation, cutoff development, and performance in patients with acute myelogenous leukemia and myelodysplastic syndrome.  Clin Infect Dis. 2004;  39 (2) 199-205
    CrossrefPubMedGoogle Scholar
  • 83 Fukazawa Y. Antigenic structure of Candida albicans: immunochemical basis of the serologic specificity of the mannans in yeasts.  Immunol Ser. 1989;  47 37-62
    PubMedGoogle Scholar
  • 84 Sendid B, Tabouret M, Poirot J L, Mathieu D, Fruit J, Poulain D. New enzyme immunoassays for sensitive detection of circulating Candida albicans mannan and antimannan antibodies: useful combined test for diagnosis of systemic candidiasis.  J Clin Microbiol. 1999;  37 (5) 1510-1517
    PubMedGoogle Scholar
  • 85 Moragues M D, Ortiz N, Iruretagoyena J R et al.. Evaluation of a new commercial test (Candida albicans IFA IgG) for the serodiagnosis of invasive candidiasis [in Spanish].  Enferm Infecc Microbiol Clin. 2004;  22 (2) 83-88
    PubMedGoogle Scholar
  • 86 Berzaghi R, Colombo A L, Machado A M, de Camargo Z P. New approach for diagnosis of candidemia based on detection of a 65-kilodalton antigen.  Clin Vaccine Immunol. 2009;  16 (11) 1538-1545
    CrossrefPubMedGoogle Scholar
  • 87 Ahmad S, Khan Z, Mustafa A S, Khan Z U. Seminested PCR for diagnosis of candidemia: comparison with culture, antigen detection, and biochemical methods for species identification.  J Clin Microbiol. 2002;  40 (7) 2483-2489
    CrossrefPubMedGoogle Scholar
  • 88 McMullan R, Metwally L, Coyle P V et al.. A prospective clinical trial of a real-time polymerase chain reaction assay for the diagnosis of candidemia in nonneutropenic, critically ill adults.  Clin Infect Dis. 2008;  46 (6) 890-896
    CrossrefPubMedGoogle Scholar
  • 89 Schuster M G, Edwards Jr J E, Sobel J D et al.. Empirical fluconazole versus placebo for intensive care unit patients: a randomized trial.  Ann Intern Med. 2008;  149 (2) 83-90
    PubMedGoogle Scholar
  • 90 Lam S W, Eschenauer G A, Carver P L. Evolving role of early antifungals in the adult intensive care unit.  Crit Care Med. 2009;  37 (5) 1580-1593
    CrossrefPubMedGoogle Scholar
  • 91 Ostrosky-Zeichner L, Sable C, Sobel J et al.. Multicenter retrospective development and validation of a clinical prediction rule for nosocomial invasive candidiasis in the intensive care setting.  Eur J Clin Microbiol Infect Dis. 2007;  26 (4) 271-276
    CrossrefPubMedGoogle Scholar
  • 92 Faiz S, Neale B, Rios E et al.. Risk-based fluconazole prophylaxis of Candida bloodstream infection in a medical intensive care unit.  Eur J Clin Microbiol Infect Dis. 2009;  28 (6) 689-692
    CrossrefPubMedGoogle Scholar
  • 93 Garbino J, Lew D P, Romand J A, Hugonnet S, Auckenthaler R, Pittet D. Prevention of severe Candida infections in nonneutropenic, high-risk, critically ill patients: a randomized, double-blind, placebo-controlled trial in patients treated by selective digestive decontamination.  Intensive Care Med. 2002;  28 (12) 1708-1717
    CrossrefPubMedGoogle Scholar
  • 94 Garey K W, Neuhauser M M, Bearden D T et al.. Evaluation of antifungals in the surgical intensive care unit: a multi-institutional study.  Mycoses. 2006;  49 (3) 226-231
    CrossrefPubMedGoogle Scholar
  • 95 Shorr A F, Chung K, Jackson W L, Waterman P E, Kollef M H. Fluconazole prophylaxis in critically ill surgical patients: a meta-analysis.  Crit Care Med. 2005;  33 (9) 1928-1935 quiz 1936
    CrossrefPubMedGoogle Scholar
  • 96 Playford E G, Webster A C, Sorrell T C, Craig J C. Antifungal agents for preventing fungal infections in non-neutropenic critically ill patients.  Cochrane Database Syst Rev. 2006;  (1) CD004920
    PubMedGoogle Scholar
  • 97 Eggimann P, Francioli P, Bille J et al.. Fluconazole prophylaxis prevents intra-abdominal candidiasis in high-risk surgical patients.  Crit Care Med. 1999;  27 (6) 1066-1072
    CrossrefPubMedGoogle Scholar
  • 98 Magill S S, Swoboda S M, Shields C E et al.. The epidemiology of Candida colonization and invasive candidiasis in a surgical intensive care unit where fluconazole prophylaxis is utilized: follow-up to a randomized clinical trial.  Ann Surg. 2009;  249 (4) 657-665
    CrossrefPubMedGoogle Scholar
  • 99 Bassetti M, Ansaldi F, Nicolini L et al.. Incidence of candidaemia and relationship with fluconazole use in an intensive care unit.  J Antimicrob Chemother. 2009;  64 (3) 625-629
    CrossrefPubMedGoogle Scholar
  • 100 Rocco T R, Reinert S E, Simms H H. Effects of fluconazole administration in critically ill patients: analysis of bacterial and fungal resistance.  Arch Surg. 2000;  135 (2) 160-165
    CrossrefPubMedGoogle Scholar
  • 101 Pappas P G, Kauffman C A, Andes D Infectious Diseases Society of America et al. Clinical practice guidelines for the management of candidiasis: 2009 update by the Infectious Diseases Society of America.  Clin Infect Dis. 2009;  48 (5) 503-535
    CrossrefPubMedGoogle Scholar
  • 102 Hadley S, Huckabee C, Pappas P G et al.. Outcomes of antifungal prophylaxis in high-risk liver transplant recipients.  Transpl Infect Dis. 2009;  11 (1) 40-48
    CrossrefPubMedGoogle Scholar
  • 103 Benedetti E, Gruessner A C, Troppmann C et al.. Intra-abdominal fungal infections after pancreatic transplantation: incidence, treatment, and outcome.  J Am Coll Surg. 1996;  183 (4) 307-316
    PubMedGoogle Scholar
  • 104 Guaraldi G, Cocchi S, Codeluppi M et al.. Outcome, incidence, and timing of infectious complications in small bowel and multivisceral organ transplantation patients.  Transplantation. 2005;  80 (12) 1742-1748
    CrossrefPubMedGoogle Scholar
  • 105 Parkins M D, Sabuda D M, Elsayed S, Laupland K B. Adequacy of empirical antifungal therapy and effect on outcome among patients with invasive Candida species infections.  J Antimicrob Chemother. 2007;  60 (3) 613-618
    CrossrefPubMedGoogle Scholar
  • 106 Shan Y S, Sy E D, Wang S T, Lee J C, Lin P W. Early presumptive therapy with fluconazole for occult Candida infection after gastrointestinal surgery.  World J Surg. 2006;  30 (1) 119-126
    CrossrefPubMedGoogle Scholar
  • 107 Taur Y, Cohen N, Dubnow S, Paskovaty A, Seo S K. Effect of antifungal therapy timing on mortality in cancer patients with candidemia.  Antimicrob Agents Chemother. 2010;  54 (1) 184-190
    CrossrefPubMedGoogle Scholar
  • 108 Rex J H, Bennett J E, Sugar A M Candidemia Study Group and the National Institute et al. A randomized trial comparing fluconazole with amphotericin B for the treatment of candidemia in patients without neutropenia.  N Engl J Med. 1994;  331 (20) 1325-1330
    CrossrefPubMedGoogle Scholar
  • 109 Phillips P, Shafran S, Garber G Canadian Candidemia Study Group et al. Multicenter randomized trial of fluconazole versus amphotericin B for treatment of candidemia in non-neutropenic patients.  Eur J Clin Microbiol Infect Dis. 1997;  16 (5) 337-345
    CrossrefPubMedGoogle Scholar
  • 110 Mora-Duarte J, Betts R, Rotstein C Caspofungin Invasive Candidiasis Study Group et al. Comparison of caspofungin and amphotericin B for invasive candidiasis.  N Engl J Med. 2002;  347 (25) 2020-2029
    CrossrefPubMedGoogle Scholar
  • 111 DiNubile M J, Lupinacci R J, Strohmaier K M, Sable C A, Kartsonis N A. Invasive candidiasis treated in the intensive care unit: observations from a randomized clinical trial.  J Crit Care. 2007;  22 (3) 237-244
    CrossrefPubMedGoogle Scholar
  • 112 Betts R F, Nucci M, Talwar D Caspofungin High-Dose Study Group et al. A multicenter, double-blind trial of a high-dose caspofungin treatment regimen versus a standard caspofungin treatment regimen for adult patients with invasive candidiasis.  Clin Infect Dis. 2009;  48 (12) 1676-1684
    CrossrefPubMedGoogle Scholar
  • 113 Pappas P G, Rotstein C M, Betts R F et al.. Micafungin versus caspofungin for treatment of candidemia and other forms of invasive candidiasis.  Clin Infect Dis. 2007;  45 (7) 883-893
    CrossrefPubMedGoogle Scholar
  • 114 Reboli A C, Rotstein C, Pappas P G Anidulafungin Study Group et al. Anidulafungin versus fluconazole for invasive candidiasis.  N Engl J Med. 2007;  356 (24) 2472-2482
    CrossrefPubMedGoogle Scholar
  • 115 Ostrosky-Zeichner L, Oude Lashof A M, Kullberg B J, Rex J H. Voriconazole salvage treatment of invasive candidiasis.  Eur J Clin Microbiol Infect Dis. 2003;  22 (11) 651-655
    CrossrefPubMedGoogle Scholar
  • 116 Kullberg B J, Sobel J D, Ruhnke M et al.. Voriconazole versus a regimen of amphotericin B followed by fluconazole for candidaemia in non-neutropenic patients: a randomised non-inferiority trial.  Lancet. 2005;  366 (9495) 1435-1442
    CrossrefPubMedGoogle Scholar
  • 117 Rex J H, Pappas P G, Karchmer A W National Institute of Allergy and Infectious Diseases Mycoses Study Group et al. A randomized and blinded multicenter trial of high-dose fluconazole plus placebo versus fluconazole plus amphotericin B as therapy for candidemia and its consequences in nonneutropenic subjects.  Clin Infect Dis. 2003;  36 (10) 1221-1228
    CrossrefPubMedGoogle Scholar
  • 118 Pachl J, Svoboda P, Jacobs F Mycograb Invasive Candidiasis Study Group et al. A randomized, blinded, multicenter trial of lipid-associated amphotericin B alone versus in combination with an antibody-based inhibitor of heat shock protein 90 in patients with invasive candidiasis.  Clin Infect Dis. 2006;  42 (10) 1404-1413
    CrossrefPubMedGoogle Scholar
  • 119 Karwa R, Wargo K A. Efungumab: a novel agent in the treatment of invasive candidiasis.  Ann Pharmacother. 2009;  43 (11) 1818-1823
    CrossrefPubMedGoogle Scholar
  • 120 Kuse E-R, Chetchotisakd P, da Cunha C A Micafungin Invasive Candidiasis Working Group et al. Micafungin versus liposomal amphotericin B for candidaemia and invasive candidosis: a phase III randomised double-blind trial.  Lancet. 2007;  369 (9572) 1519-1527
    CrossrefPubMedGoogle Scholar
  • 121 Rex J H, Bennett J E, Sugar A M NIAID Mycoses Study Group and the Candidemia Study Group et al. Intravascular catheter exchange and duration of candidemia.  Clin Infect Dis. 1995;  21 (4) 994-996
    CrossrefPubMedGoogle Scholar
  • 122 Horn D L, Ostrosky-Zeichner L, Morris M I et al.. Factors related to survival and treatment success in invasive candidiasis or candidemia: a pooled analysis of two large, prospective, micafungin trials.  Eur J Clin Microbiol Infect Dis. 2010;  29 (2) 223-229
    CrossrefPubMedGoogle Scholar
  • 123 Nucci M, Anaissie E, Betts R F et al.. Early removal of central venous catheter in patients with candidemia does not improve outcome: analysis of 842 patients from 2 randomized clinical trials.  Clin Infect Dis. 2010;  51 (3) 295-303
    CrossrefPubMedGoogle Scholar

Élie AzoulayM.D. Ph.D. 

Hôpital Saint-Louis, Service de Reanimation

1 Avenue Claude Vellefaux, 75010 Paris, France

Email: elie.azoulay@sls.aphp.fr

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