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Invasive Candidiasis
Published in Firza Alexander Gronthoud, Practical Clinical Microbiology and Infectious Diseases, 2020
Risk factors for invasive candidiasis: Mucositis due to chemo- or radiotherapy (damage to mucosa allowing for translocation)Intravascular catheter (i.e. patients on dialysis, total parenteral nutrition or chemotherapy)Intravenous drug useIntra-abdominal surgery (intra-abdominal contamination with Candida spp.)Immunosuppression (particularly neutropaenia facilitates Candida dissemination)Broad-spectrum antibacterial agents (promotes Candida overgrowth)
Rapid Infectious Diseases Diagnostics in the Critical Care Unit
Published in Cheston B. Cunha, Burke A. Cunha, Infectious Diseases and Antimicrobial Stewardship in Critical Care Medicine, 2020
Bronwen Garner, Kimberly Hanson
Candida is the third most common cause of BSI in the CCU [91]. The incidence of invasive candidiasis (IC), however, may vary widely based on clinical and host-associated risk factors for disease. A large epidemiologic study carried out in patients who stayed at least 4 days in one of 12 participating medical and surgical CCUs observed a candidemia prevalence of 3% across general critical care settings [92]. However, patients with multiple IC risk factors fulfilling prediction rule criteria have a higher prevalence (~10%) [93,94], and rates of intra-abdominal candidiasis may be exceptionally high (~30%) in surgical CCU patients with biliary leaks or gastro/duodenal perforation [95,96]. The overall mortality due to IC in CCU patients is comparable a those with severe sepsis and septic shock. Blood culture remains the diagnostic standard for Candida BSI but has a poor sensitivity as a result of the generally low numbers of yeast cells circulating in the blood [97]. Additionally, average time to culture positivity ranges from 2–5 days, and delays in antifungal treatment are directly associated with increased mortality [98].
Fungal infections causing emergencies
Published in Biju Vasudevan, Rajesh Verma, Dermatological Emergencies, 2019
R. Madhu, Pradeesh Arumugam, V. Hari Pankaj
Invasive candidiasis (IC) is a spectrum of syndromes, including (a) bloodstream infection (BSI) or candidemia, (b) deep-seated Candida infections in the presence of BSI, and (c) deep-seated infections without BSI. Each contributes to almost a third of intensive care unit invasive candidiasis. The main species of Candida that are found to cause IC are Candida albicans, Candida glabrata, Candida parapsilosis, Candida krusei, and Candida tropicalis. Candida parapsilosis has the tendency to cause device and central catheter infections. Bronchial Candida isolates are generally considered nonpathogenic and reflect colonization.
An evaluation of ibrexafungerp for the treatment of invasive candidiasis: the evidence to date
Published in Expert Opinion on Pharmacotherapy, 2021
Rhonda E Colombo, Jose A Vazquez
Invasive candidiasis is a significant cause of infection-related morbidity and mortality. The increasing rate of nosocomial candidemia represents a major threat, particularly due to the emergence of multidrug-resistant Candida species, such as C. glabrata and C. auris. There are currently a limited number of antifungal options for the treatment of invasive candidiasis, and each agent has certain limitations. Unfortunately, echinocandins, the preferred initial therapy for candidemia and invasive candidiasis, are only available in intravenous formulations. Azoles, a mainstay of candidal treatment, are plagued by increasing resistance concerns and potential drug–drug interactions. Polyenes are hampered by drug-associated toxicities, as well as the need for intravenous administration. Thus, there remains a need for an additional potent antifungal agent with activity against resistant fungal pathogens, has a good bioavailability profile, is safe and easy to use, and finally, is effective in the treatment of candidemia and invasive candidiasis.
The interplay between gut bacteria and the yeast Candida albicans
Published in Gut Microbes, 2021
Several yeasts of the genus Candida are considered true symbionts of the human gut.26Candida albicans, however, is the species of the genus Candida most frequently detected in feces of healthy humans.27–29 This species, therefore, is considered a ubiquitous member of the human gut microbiota. Candida albicans appears to have no major environmental reservoir, suggesting that it has extensively coevolved with humans and cohabiting microbes. The fungus can be found in other body sites beyond the intestine (e.g. mouth, skin, vagina) and is a common cause of fastidious mucosal disease in otherwise healthy people.30C. albicans can also disseminate from the human gut into the bloodstream and invade internal organs producing invasive, life-threatening infections.31,32 Invasive Candida infections rank in the top four hospital-associated bloodstream infections in the United States.33,34 Common risk factors for invasive candidiasis include intensive care unit stay, central venous catheter use, broad-spectrum antibiotics, recent abdominal surgery and immune suppression.33,35
Neonatal fluid and electrolytes profile effect on amphotericin B associated nephrotoxicity in neonatal tertiary care unit of Karachi-Pakistan
Published in Expert Opinion on Drug Safety, 2020
Gul Ambreen, Arshalooz Rehman, Kashif Hussain, Mehreen Sohail, Saba Javed, Syed Shamim, Umer Ali, Khalil Ahmad, Arjumand Rizvi
Invasive candidiasis (IC) was diagnosed based on clinical grounds and/or laboratory results. The clinical manifestations of IC were the worsening status of apnea, bradycardia, ventilatory support, acidosis, hypotension, hyperglycemia, leukopenia, leukocytosis, and thrombocytopenia despite persistent therapeutic support. Neonates with IC had at least 2 of the above on clinical presentation [10,27]. Laboratory results included the blood, urine, tracheal aspirate and cerebrospinal fluid, etc. cultures positive for fungal growth. The blood culture is comparatively insensitive for detecting deep IC [31], therefore, non-culture-based methods, such as raised serum levels of BDG >80 pg/mL are significant laboratory tools for the diagnosis of IC [18,19]. For positive results, repeat culture was done every 48 hours, especially blood cultures until negative results were documented. In addition, neonates with IC underwent a renal ultrasonographic and echocardiographic evaluation to rule out fungal bezoars.