Abstract
nvasive candidiasis is an extremely important problem for severe patients in intensive care units. The high rates of attributive mortality are associated not only with the severity of the patient’s condition, but also with a delayed therapy due to not always available or not validated early diagnostic tests, limitations of conventional microbiological studies, and a non-specific clinical picture which prevent clinicians from suspecting a systemic Candida infection. The development of prognostic rules to identify patients with high or low invasive candidiasis risk based on microbiological and/or clinical characteristics seems to be the most available approach which has been confirmed in the prospective studies. This article describes the common prognostic rules and discusses the possible options of their implementation in clinical practice.
Institute of Antimicrobial Chemotherapy, Smolensk State Medical University, Smolensk, Russia
-
1.
Petri M., Konig J., Moecke H., et al. Epidemiology of invasive mycosis in ICU patients: a prospective multicenter study in 435 non-neutropenic patients. Intensive Care Med. 1997;23:317-325.
-
2.
Vincent J., Rello J., Marshall J., et al. International study of the prevalence and outcomes of infection in intensive care units. JAMA. 2009;302(21):23232329.
-
3.
Bougnoux M., Kac G., Aegerter P., et al. Candidemia and candiduria in critically ill patients admitted to intensive care units in France: incidence, molecular diversity, management, and outcome. Intensive Care Med. 2008;34:292-299.
-
4.
Bloos F., Bayer O., Sachse S., et al. Attributable costs of patients with candidemia and potential implications of polymerase chain reaction-based pathogen detection on antifungal therapy in patients with sepsis. J Crit Care. 2013;28:2-8.
-
5.
Blumberg H., Jarvis W., Soucie J., et al. Risk factors for candidal bloodstream infections in surgical intensive care unit patients: the NEMIS prospective multicenter study. The National Epidemiology of Mycosis Survey. Clin Infect Dis. 2001;33:177-186.
-
6.
Rangel-Frausto M., Wiblin T., Blumberg H., et al. National epidemiology of mycoses survey (NEMIS): variations in rates of bloodstream infections due to Candida species in seven surgical intensive care units and six neonatal intensive care units. Clin Infect Dis. 1999,29:253-258.
-
7.
Tabah A., Koulenti D., Laupland K., et al. Characteristics and determinants of outcome of hospital-acquired bloodstream infections in intensive care units: the EUROBACT International Cohort Study. Intensive Care Med. 2012;38:1930-1945.
-
8.
Garrouste-Orgeas M., Timsit J., Tafflet M., et al. Excess risk of death from intensive care unit-acquired nosocomial bloodstream infections: a reappraisal. Clin Infect Dis. 2006;42:1118-1126.
-
9.
Wisplinghoff H., Bischoff T., Tallent S., et al. Nosocomial bloodstream infections in US hospitals: analysis of 24,179 cases from a prospective nationwide surveillance study. Clin Infect Dis. 2004;39:309-317.
-
10.
Gudlaugsson O., Gillespie S., Lee K., et al. Attributable mortality of nosocomial candidemia, revisited. Clin Infect Dis. 2003;37:1172-1177.
-
11.
Falagas M., Apostolou K., Pappas V. Attributable mortality of candidemia: a systematic review of matched cohort and case-control studies. Eur J Clin Microbiol Infect Dis. 2006;25:419-425.
-
12.
Eggimann P., Garbino J., Pittet D. Epidemiology of Candida species infections in critically ill non-immunosuppressed patients. Lancet Infect Dis. 2003;3:685-702.
-
13.
Charles P., Dalle F., Aube H., et al. Candida spp. colonization significance in critically ill medical patients: a prospective study. Intensive Care Med. 2005;31:393-400.
-
14.
Pittet D., Monod M., Suter P., Frenk E., Auckenthaler R. Candida colonization and subsequent infections in critically ill surgical patients. Ann Surg. 1994;220:751-758.
-
15.
Moore E., Padiglione A., Wasiak J., Paul E., Cleland H. Candida in burns: risk factors and outcomes. J Burn Care Res. 2010;31(2):257-263.
-
16.
Lahmer T., Messer M., Mayr U., et al. Fungal "colonisation" is associated with increased mortality in medical intensive care unit patients with liver cirrhosis. Mycopathologia. 2015;179(1-2):63-71.
-
17.
Garey K., Rege M., Pai M., et al. Time to initiation of fluconazole therapy impacts mortality in patients with candidemia: a multi-institutional study. Clin Infect Dis. 2006;43:25-31.
-
18.
Morrell M., Fraser V., Kollef M. 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;49:3640-3645.
-
19.
Playford E., Webster A., Sorrell T., Craig J. Antifungal agents for preventing fungal infections in non-neutropenic critically-ill and surgical patients: systematic review and meta-analysis of randomized clinical trials. J Antimicrob Chemother. 2006;57:628-638.
-
20.
Rouzé A., Loridant S., Poissy J., et al. Biomarker-based strategy for early discontinuation of empirical antifungal treatment in critically ill patients: a randomized controlled trial. Intensive Care Med. 2017;43(11):1668-1677.
-
21.
Jaijakul S., Vazquez J., Swanson R., Ostrosky-Zeichner L. (1,3)-b-D-glucan as a prognostic marker of treatment response in invasive candidiasis. Clin Infect Dis. 2012;55:521-526.
-
22.
Poissy J., Sendid B., Damiens S., et al. Presence of Candida cell wall derived polysaccharides in the sera of intensive care unit patients: relation with candidaemia and Candida colonisation. Crit Care. 2014;18:R135.
-
23.
Karageorgopoulos D., Vouloumanou E., Ntziora F., et al. b-D-glucan assay for the diagnosis of invasive fungal infections: a meta-analysis. Clin Infect Dis. 2011;52:750-770.
-
24.
Mikulska M., Calandra T., Sanguinetti M., Poulain D., Viscoli C. The use of mannan antigen and anti-mannan antibodies in the diagnosis of invasive candidiasis: recommendations from the Third European Conference on Infections in Leukemia. Crit Care. 2010;14:R222.
-
25.
Martínez-Jiménez M., Muñoz P., Valerio M., et al. Candida biomarkers in patients with candidaemia and bacteraemia. J Antimicrob Chemother. 2015;70(8):2354-2361.
-
26.
Martínez-Jiménez M., Muñoz P., Valerio M., Vena A., Guinea J., Bouza E. Combination of Candida biomarkers in patients receiving empirical antifungal therapy in a Spanish tertiary hospital: a potential role in reducing the duration of treatment. J Antimicrob Chemother. 2015;70(11):3107-3115.
-
27.
Nguyen M., Wissel M., Shields R., et al. Performance of Candida real-time polymerase chain reaction, b-D-glucan assay, and blood cultures in the diagnosis of invasive candidiasis. Clin Infect Dis. 2012;54:1240-1248.
-
28.
Beyda N., Alam M., Garey K. Comparison of the T2Dx instrument with T2Candida assay and automated blood culture in the detection of Candida species using seeded blood samples. Diagn Microbiol Infect Dis. 2013;77:324-326.
-
29.
Dupont H., Bourichon A., PaugamBurtz C., Mantz J., Desmonts J. Can yeast isolation in peritoneal fluid be predicted in intensive care unit patients with peritonitis? Crit Care Med. 2003;31:752757.
-
30.
Michalopoulos A., Geroulanos S., Mentzelopoulos S. Determinants of candidemia and candidemiarelated death in cardiothoracic ICU patients. Chest. 2003;124:22442255.
-
31.
Paphitou N., OstroskyZeichner L., Rex J. Rules for identifying patients at increased risk for candidal infections in the surgical intensive care unit: Approach to developing practical criteria for systematic use in antifungal prophylaxis trials. Med Mycol. 2005;43:235243.
-
32.
León C., Ruiz-Santana S., Saavedra P., et al. A bedside scoring system (“Candida score”) for early antifungal treatment in nonneutropenic critically ill patients with Candida colonization. Crit Care Med. 2006;34:730-737.
-
33.
OstroskyZeichner 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;26:271276.
-
34.
Shorr A., Tabak Y., Johannes R., et al. Candidemia on presentation to the hospital: development and validation of a risk score. Crit Care. 2009;13(5):R156.
-
35.
OstroskyZeichner L., Pappas P., 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;54:4651.
-
36.
Shahin J., Allen E., Patel K., et al. Predicting invasive fungal disease due to Candida species in non-neutropenic, critically ill, adult patients in United Kingdom critical care units. BMC Infect Dis. 2016;16:480.
-
37.
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;32:2443-2449.
-
38.
León C., Ostrosky-Zeichner L., Schuster M. What’s new in the clinical and diagnostic management of invasive candidiasis in critically ill patients. Intensive Care Med. 2014;40:808-819.
-
39.
Hall A., Poole L., Renton B., et al. Prediction of invasive candidal infection in critically ill patients with severe acute pancreatitis. Crit Care. 2013;17:R49.
-
40.
Hermsen E., Zapapas M., Maiefski M., et al. Validation and comparison of clinical prediction rules for invasive candidiasis in intensive care unit patients: a matched case-control study. Crit Care. 2011;15:R198.
-
41.
Playford E., Lipman J., Kabir M., et al. Assessment of clinical risk predictive rules for invasive candidiasis in a prospective multicentre cohort of ICU patients. Intensive Care Med. 2009;35:2141-2145.
-
42.
Leon C., Ruiz-Santana S., Saavedra P., 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;37:1624-1633.
-
43.
Leroy G., Lambiotte F., Thevenin D., et al. Evaluation of “Candida score” in critically ill patients: a prospective, multicenter, observational, cohort study. Ann Intensive Care. 2011;1:50.
-
44.
Bruyère R., Quenot J., Prin S., et al. Empirical antifungal therapy with an echinocandin in critically-ill patients: prospective evaluation of a pragmatic Candida score-based strategy in one medical ICU. BMC Infect Dis. 2014;14:385.
-
45.
Umberger R., Garsee K., Davidson B., et al. The Utility of the Candida Score in Patients With Sepsis. Dimens Crit Care Nurs. 2016;35(2):92-98.
-
46.
Playford E., Lipman J., Jones M., et al. Problematic Dichotomization of Risk for Intensive Care Unit (ICU)-Acquired Invasive Candidiasis: Results Using a Risk-Predictive Model to Categorize 3 Levels of Risk From a Multicenter Prospective Cohort of Australian ICU Patients. Clin Infect Dis. 2016;63(11):1463-1469.
-
47.
Eggimann P., Ostrosky-Zeichner L. Early antifungal intervention strategies in ICU patients. Curr Opin Crit Care. 2010;16:465-469.
-
48.
Eggimann P., Pittet D. Candida colonization index and subsequent infection in critically ill surgical patients: 20 years later. Intensive Care Med. 2014;40:1429-1448.
-
49.
van Engen A., Casamayor M., Kim S., Watt M., Odeyemi I. "De-escalation" strategy using micafungin for the treatment of systemic Candida infections: budget impact in France and Germany. Clinicoecon Outcomes Res. 2017;9:763-774.
-
50.
Tascini C., Sozio E., Salini N., et al. Risk factors for candidaemia in critically ill patients in intensive care units as compared to internal medicine wards. Infect Dis (Lond). 2017;49(2):153-154.
-
51.
Bassetti M., Peghin M., Timsit J. The current treatment landscape: candidiasis. J Antimicrob Chemother. 2016;71(Suppl. 2):ii13-ii22.
-
52.
Diagnosis and treatment of mycoses in intensive care units: Russian recommendations. Klimko N.N., ed. 2nd Edition. M.: Farmtek, 2015. 96 p. Russian.
-
53.
Kawano Y., Togawa A., Nakamura Y., et al. Prognostic factors for candidaemia in intensive care unit patients: a retrospective analysis. Singapore Med J. 2017;58(4):196-200.
-
54.
Ostrosky-Zeichner L., Harrington R., Azie N., et al. A Risk Score for Fluconazole Failure among Patients with Candidemia. Antimicrob Agents Chemother. 2017;61(5).pii:e02091-16.
-
55.
Cuervo G., Puig-Asensio M., Garcia-Vidal C., et al. A simple prediction score for estimating the risk of candidaemia caused by fluconazole nonsusceptible strains. Clin Microbiol Infect. 2015;21(7):684.e1-9.
-
56.
Arendrup M.C. Candida and candidaemia. Susceptibility and epidemiology. Dan Med J. 2013;60(11):B4698.
-
57.
Guillamet C., Vazquez R., Micek S., Ursu O., Kollef M. Development and validation of a clinical prediction rule for candidemia in hospitalized patients with severe sepsis and septic shock. J Crit Care. 2015;30(4):715-720.
-
58.
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;137:1341-1346.
-
59.
Montravers P., Dupont H., Gauzit R., et al. Candida as a risk factor for mortality in peritonitis. Crit Care Med. 2006;34:646-652.
-
60.
Bassetti M., Leon C., Timsit J. Are prophylactic antifungals in highly colonized patients safe and effective? Intensive Care Med. 2015;41:1336-1339.
-
61.
Tissot F., Lamoth F., Hauser P., et al. β-glucan antigenemia anticipates diagnosis of blood culture-negative intraabdominal candidiasis. Am J Respir Crit Care Med. 2013;188(9):1100-1109.
-
62.
Posteraro B., Tumbarello M., De Pascale G., et al. (1,3)-β-d-Glucan-based antifungal treatment in critically ill adults at high risk of candidaemia: an observational study. J Antimicrob Chemother. 2016;71(8):2262-2269.
-
63.
Bailly S., Leroy O., Montravers P., et al. Antifungal de-escalation was not associated with adverse outcome in critically ill patients treated for invasive candidiasis: post hoc analyses of the AmarCAND2 study data. Intensive Care Med. 2015;41(11):1931-1940.