Microbiology
Fungal infections
Fungal infections in the ICU are a significant cause of morbidity and mortality, particularly in immunocompromised or critically ill patients. Common fungal pathogens, such as Candida and Aspergillus, require early recognition and timely antifungal therapy. Diagnostic challenges necessitate the use of biomarkers and advanced testing methods. Effective management strategies include empiric and targeted antifungal treatments, along with preventive measures to reduce the risk of infection.
Invasive candidiasis is a life-threatening condition that requires prompt diagnosis and appropriate antifungal therapy. Risk factors and clinical predictors are crucial for early identification, and preventive measures are essential to improve outcomes in critically ill patients.
Aspergillus diseases, particularly invasive aspergillosis, are associated with high mortality rates. Accurate diagnosis involves imaging, biomarkers, and microbiological testing. Targeted antifungal therapy, including triazoles and amphotericin B, is essential for managing these infections. Prophylaxis strategies are also important for high-risk patients to prevent the development of Aspergillus infections.
General approach to fungal infections in the ICU
Fungal infections
Fungal infections and critically ill adults
Martin Beed et al., Continuing Education in Anaesthesia Critical Care & Pain (2014)
What’s inside
This article reviews the epidemiology, diagnosis, and management of fungal infections in critically ill adults, focusing on risk factors, clinical presentation, and treatment strategies.
Why it’s relevant
Fungal infections are a significant cause of morbidity and mortality in critically ill patients, particularly those with prolonged ICU stays or immunocompromised states.
Key focus
- Common fungal pathogens (e.g., Candida, Aspergillus) and their risk factors
- Diagnostic challenges and the role of biomarkers (e.g., beta-D-glucan)
- Antifungal therapy options, including empiric and targeted treatments
- Strategies for prevention and infection control
Takeaway
The article highlights the importance of early recognition, accurate diagnosis, and timely antifungal therapy in managing fungal infections. It also underscores the need for preventive measures in high-risk critically ill populations.
Invasive candidiasis
Invasive candidiasis
ESICM/ESCMID task force on practical management of invasive candidiasis in critically ill patients
Ignacio Martin-Loeches et al., Intensive Care Medicine (2019)
What’s inside
This article provides practical recommendations from the ESICM/ESCMID task force for the management of invasive candidiasis in critically ill patients, covering diagnosis, treatment, and prevention.
Why it’s relevant
Invasive candidiasis is a life-threatening condition with high mortality rates in critically ill patients, necessitating timely and effective management strategies.
Key focus
- Risk factors and clinical predictors of invasive candidiasis
- Diagnostic approaches, including biomarkers and cultures
- Antifungal therapy options, including empiric and targeted treatments
- Strategies for prevention and antifungal stewardship
Takeaway
The guidelines emphasize early diagnosis, appropriate antifungal therapy, and preventive measures to improve outcomes in critically ill patients with invasive candidiasis.
Aspergillus diseases
Aspergillus
Diagnosis and management of Aspergillus diseases: executive summary of the 2017 ESCMID-ECMM-ERS guideline
A.J. Ullmann et al., Clinical Microbiology and Infection (2018)
What’s inside
This article summarizes the 2017 ESCMID-ECMM-ERS guidelines for the diagnosis and management of Aspergillus diseases, providing evidence-based recommendations for clinical practice.
Why it’s relevant
Aspergillus infections, particularly invasive aspergillosis, are associated with high mortality, especially in immunocompromised patients, requiring accurate diagnosis and effective treatment.
Key focus
- Diagnostic criteria, including imaging, biomarkers (e.g., galactomannan), and microbiological testing
- Antifungal therapy options, including triazoles and amphotericin B
- Management of specific conditions, such as chronic pulmonary aspergillosis and allergic forms
- Strategies for prophylaxis in high-risk patients
Takeaway
The guidelines emphasize a multidisciplinary approach to diagnosing and managing Aspergillus diseases, integrating advanced diagnostics, targeted antifungal therapy, and preventive measures to improve patient outcomes.
For fungal infections in immunocompromised patients, look here.