A Narrative Review of Invasive Candidiasis in the Intensive Care Unit.

0 RESPIRATORY SYSTEM Therapeutic advances in pulmonary and critical care medicine Pub Date : 2024-12-12 eCollection Date: 2024-01-01 DOI:10.1177/29768675241304684
Elnè Noppè, Julian Robert Paul Eloff, Sean Keane, Ignacio Martin-Loeches
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Abstract

Candida species is the most common cause of invasive fungal infection in the critically ill population admitted to the intensive care unit (ICU). Numerous risk factors for developing invasive candidiasis (IC) have been identified, and some, like the breach of protective barriers, abound within the ICU. Given that IC carries a significant mortality, morbidity, and healthcare cost burden, early diagnosis and treatment have become an essential topic of discussion. Several expert panels and task forces have been established to provide clear guidance on the management of IC. Unfortunately, IC remains a diagnostic and therapeutic challenge attributable to the changing fungal ecology of Candida species and the emergence of multidrug-resistant strains. This narrative review will focus on the following: (1) the incidence, outcomes, and changing epidemiology of IC globally; (2) the risk factors for developing IC; (3) IC risk stratification tools and their appropriate use; (4) diagnosis of IC; and (5) therapeutic agents and regimens.

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侵袭性念珠菌病在重症监护室的叙述回顾。
念珠菌是重症监护病房(ICU)危重患者侵袭性真菌感染的最常见原因。侵袭性念珠菌病(IC)的许多危险因素已被确定,其中一些,如保护屏障的破坏,在ICU内比比皆是。鉴于IC具有显著的死亡率、发病率和医疗成本负担,早期诊断和治疗已成为讨论的基本主题。已经成立了几个专家小组和工作组,为IC的管理提供明确的指导。不幸的是,由于念珠菌物种的真菌生态变化和多重耐药菌株的出现,IC仍然是诊断和治疗的挑战。这篇综述将集中在以下方面:(1)全球IC的发病率、结局和不断变化的流行病学;(2)发生IC的危险因素;(3) IC风险分层工具及其合理使用;(4) IC诊断;(5)治疗药物和方案。
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