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Semin Respir Crit Care Med 2019; 40(04): 524-539
DOI: 10.1055/s-0039-1693704
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Diagnosis and Treatment of Candidemia in the Intensive Care Unit

Authors

  • Matteo Bassetti

    1   Department of Medicine, Infectious Diseases Clinic, University of Udine and Azienda Sanitaria Universitaria Integrata di Udine, Udine, Italy
    2   Department of Health Sciences, University of Genoa, Genoa, Italy

  • Daniele R. Giacobbe

    2   Department of Health Sciences, University of Genoa, Genoa, Italy

  • Antonio Vena

    1   Department of Medicine, Infectious Diseases Clinic, University of Udine and Azienda Sanitaria Universitaria Integrata di Udine, Udine, Italy

  • Michel Wolff

    3   Service de Réanimation Neuro-Chirurgicale, Centre Hospitalier Saint-Anne, Paris, France
Further Information

Publication History

Publication Date:
04 October 2019 (online)

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Abstract

Candidemia is the fourth most frequent health care-associated bloodstream infection, and the most frequent severe fungal infection developing in critically ill patients in intensive care units (ICUs). Diagnosis of candidemia in ICU patients is a complex task made of both early and late assessments involving both conventional diagnostic methods and novel rapid tests. Management strategies to optimize treatment of candidemia can be challenging and include starting early adequate therapy, use of an adequate dose and duration of therapy, de-escalating treatment whenever possible, and early discontinuation of useless antifungals in those with no definitive diagnosis of fungal infection. Herein, we will discuss recent epidemiological data on candidemia in ICUs and current diagnostic techniques before concentrating on antifungal treatments.

Keywords

Candida - ICU - diagnosis - biomarker - pre-emptive - echinocandins - source control - antifungals