Invasive fungal infections in the intensive care unit

Research output: Contribution to journalReview article

30 Citations (Scopus)

Abstract

Invasive fungal infections, especially candidemia and systemic candidiasis, have become a major cause of morbidity and mortality in the last few decades. This comes in parallel with the major advances made in intensive care. Patients who are critically ill, in medical or surgical ICUs are especially at risk for Candida infections. Invasive candidiasis accounts for up to 15 to 30% of all nosocomial infections in critically ill patients. Management of these severe infections has been challenging due to a lack of rapid and reliable diagnostic methods, leading to delays in initiating appropriate antifungal therapy. However, some notable improvements have been made in diagnostics with improved culturing methods, rapid species identification, and detection of fungemia with newer antigen assays. Newer classes of antifungals have recently become available with broader antifungal activity, fewer drugdrug interactions, and improved tolerability when compared with the older antifungal agents. Despite these advancements, the mortality rates associated with candidiasis remain excessively high, with an overall mortality in the range of 30 to 50% and an attributable mortality of ∼30%. In addition to this high case-fatality rate, candidemia is also associated with a substantial economic burden, primarily due to an extended length of stay. Strategies to evaluate either the prevention, early diagnosis, or initiation of appropriate therapy should yield both clinical and socioeconomic benefits.

Original languageEnglish (US)
Pages (from-to)79-86
Number of pages8
JournalSeminars in Respiratory and Critical Care Medicine
Volume31
Issue number1
DOIs
StatePublished - Feb 22 2010
Externally publishedYes

Fingerprint

Intensive Care Units
Mortality
Candidemia
Critical Illness
Invasive Candidiasis
Fungemia
Candidiasis
Antifungal Agents
Critical Care
Cross Infection
Infection
Candida
Early Diagnosis
Length of Stay
Economics
Invasive Fungal Infections
Morbidity
Antigens
Therapeutics

Keywords

  • Antifungals
  • Candidiasis
  • ICU
  • Outcomes
  • Systemic fungal infections

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine

Cite this

Invasive fungal infections in the intensive care unit. / Vazquez, Jose Antonio.

In: Seminars in Respiratory and Critical Care Medicine, Vol. 31, No. 1, 22.02.2010, p. 79-86.

Research output: Contribution to journalReview article

@article{d44f953ac7e24db28850d2ee2c0fc0d9,
title = "Invasive fungal infections in the intensive care unit",
abstract = "Invasive fungal infections, especially candidemia and systemic candidiasis, have become a major cause of morbidity and mortality in the last few decades. This comes in parallel with the major advances made in intensive care. Patients who are critically ill, in medical or surgical ICUs are especially at risk for Candida infections. Invasive candidiasis accounts for up to 15 to 30{\%} of all nosocomial infections in critically ill patients. Management of these severe infections has been challenging due to a lack of rapid and reliable diagnostic methods, leading to delays in initiating appropriate antifungal therapy. However, some notable improvements have been made in diagnostics with improved culturing methods, rapid species identification, and detection of fungemia with newer antigen assays. Newer classes of antifungals have recently become available with broader antifungal activity, fewer drugdrug interactions, and improved tolerability when compared with the older antifungal agents. Despite these advancements, the mortality rates associated with candidiasis remain excessively high, with an overall mortality in the range of 30 to 50{\%} and an attributable mortality of ∼30{\%}. In addition to this high case-fatality rate, candidemia is also associated with a substantial economic burden, primarily due to an extended length of stay. Strategies to evaluate either the prevention, early diagnosis, or initiation of appropriate therapy should yield both clinical and socioeconomic benefits.",
keywords = "Antifungals, Candidiasis, ICU, Outcomes, Systemic fungal infections",
author = "Vazquez, {Jose Antonio}",
year = "2010",
month = "2",
day = "22",
doi = "10.1055/s-0029-1246289",
language = "English (US)",
volume = "31",
pages = "79--86",
journal = "Seminars in Respiratory and Critical Care Medicine",
issn = "1069-3424",
publisher = "Thieme Medical Publishers",
number = "1",

}

TY - JOUR

T1 - Invasive fungal infections in the intensive care unit

AU - Vazquez, Jose Antonio

PY - 2010/2/22

Y1 - 2010/2/22

N2 - Invasive fungal infections, especially candidemia and systemic candidiasis, have become a major cause of morbidity and mortality in the last few decades. This comes in parallel with the major advances made in intensive care. Patients who are critically ill, in medical or surgical ICUs are especially at risk for Candida infections. Invasive candidiasis accounts for up to 15 to 30% of all nosocomial infections in critically ill patients. Management of these severe infections has been challenging due to a lack of rapid and reliable diagnostic methods, leading to delays in initiating appropriate antifungal therapy. However, some notable improvements have been made in diagnostics with improved culturing methods, rapid species identification, and detection of fungemia with newer antigen assays. Newer classes of antifungals have recently become available with broader antifungal activity, fewer drugdrug interactions, and improved tolerability when compared with the older antifungal agents. Despite these advancements, the mortality rates associated with candidiasis remain excessively high, with an overall mortality in the range of 30 to 50% and an attributable mortality of ∼30%. In addition to this high case-fatality rate, candidemia is also associated with a substantial economic burden, primarily due to an extended length of stay. Strategies to evaluate either the prevention, early diagnosis, or initiation of appropriate therapy should yield both clinical and socioeconomic benefits.

AB - Invasive fungal infections, especially candidemia and systemic candidiasis, have become a major cause of morbidity and mortality in the last few decades. This comes in parallel with the major advances made in intensive care. Patients who are critically ill, in medical or surgical ICUs are especially at risk for Candida infections. Invasive candidiasis accounts for up to 15 to 30% of all nosocomial infections in critically ill patients. Management of these severe infections has been challenging due to a lack of rapid and reliable diagnostic methods, leading to delays in initiating appropriate antifungal therapy. However, some notable improvements have been made in diagnostics with improved culturing methods, rapid species identification, and detection of fungemia with newer antigen assays. Newer classes of antifungals have recently become available with broader antifungal activity, fewer drugdrug interactions, and improved tolerability when compared with the older antifungal agents. Despite these advancements, the mortality rates associated with candidiasis remain excessively high, with an overall mortality in the range of 30 to 50% and an attributable mortality of ∼30%. In addition to this high case-fatality rate, candidemia is also associated with a substantial economic burden, primarily due to an extended length of stay. Strategies to evaluate either the prevention, early diagnosis, or initiation of appropriate therapy should yield both clinical and socioeconomic benefits.

KW - Antifungals

KW - Candidiasis

KW - ICU

KW - Outcomes

KW - Systemic fungal infections

UR - http://www.scopus.com/inward/record.url?scp=76749097678&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=76749097678&partnerID=8YFLogxK

U2 - 10.1055/s-0029-1246289

DO - 10.1055/s-0029-1246289

M3 - Review article

VL - 31

SP - 79

EP - 86

JO - Seminars in Respiratory and Critical Care Medicine

JF - Seminars in Respiratory and Critical Care Medicine

SN - 1069-3424

IS - 1

ER -