Consensus statement on the management of invasive candidiasis in Intensive Care Units in the Asia-Pacific Region

• Published in: International journal of antimicrobial agents Vol. 34; no. 3; pp. 205 - 209
• Main Authors: Hsueh, Po-Ren, Graybill, John Richard, Playford, E. Geoffrey, Watcharananan, Siriorn Paritpokee, Oh, Myoung-Don, Ja’alam, Kamarudin, Huang, Shunwei, Nangia, Vivek, Kurup, Asok, Padiglione, Alexander Angelo
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Amsterdam Elsevier 01.09.2009
• Subjects: Antibiotics. Antiinfectious agents. Antiparasitic agents; Antifungal Agents - therapeutic use; Asia - epidemiology; Biological and medical sciences; Candida albicans; Candidiasis - diagnosis; Candidiasis - drug therapy; Candidiasis - epidemiology; Consensus; Fluconazole - therapeutic use; Humans; Infectious Disease; Intensive Care Units; Medical sciences; Pacific Islands - epidemiology; Pharmacology. Drug treatments; Asia; Pacific Islands; Asia-Pacific; Intensive Care Unit; Invasive candidiasis; Consensus; Infection; Candidiasis; Clinical management; Mycosis; Management; Intensive care unit
• ISSN: 0924-8579; 1872-7913
• DOI: 10.1016/j.ijantimicag.2009.03.014

Abstract Invasive candidiasis has emerged as an important nosocomial infection, especially in critically ill patients. The incidence of candidaemia in Intensive Care Units (ICUs) is 5- to 10-fold higher than in the entire hospital and the crude mortality rate of patients with candidaemia is between 35% and 60%. Candida albicans remains the predominant cause of invasive candidiasis in ICUs, followed by Candida tropicalis , Candida glabrata and Candida parapsilosis . Invasive isolates of Candida spp. remain highly susceptible to fluconazole (>90% susceptible), although among Asia-Pacific countries the susceptibility rate of C. glabrata to fluconazole varies widely from 22% to 72%. Early diagnosis and prompt initiation of antifungal therapy are crucial for the effective treatment of invasive candidiasis. However, invasive candidiasis is difficult to diagnose owing to its non-specific clinical features, and delayed therapy is a major contributor to poor outcomes. Combining clinical risk factors with Candida colonisation parameters appears promising for guiding early interventions. Because of considerable regional variability, local epidemiological knowledge is critical in the effective management of invasive candidiasis among ICU patients in Asia-Pacific.