The Prevention of Invasive Candida Infection in Critically Ill Surgical Patients
Over the past three decades, the significant morbidity and mortality associated with candidemia and invasive candidiasis have been well established. Technological and scientific advancement has led to an increase in the incidence of serious Candida infections. With the introduction of the azoles and more recently with the development of the echinocandin class of antifungals, our ability to treat these infections has improved; however, our ability to diagnose these infections in a timely fashion remains limited, and patient outcomes remain poor. Antifungal prophylaxis has emerged as a method to attempt to decrease the occurrence of these serious infections in selected high-risk patient populations. The role of antifungal prophylaxis is well established in bone marrow transplant recipients [1, 2]. In this chapter, we will review the role of antifungal prophylaxis in the surgical patient, with particular attention to the prevention of candidemia and invasive candidiasis in surgical intensive care unit (ICU) patients and abdominal organ transplant recipients.
KeywordsTransplant Recipient Candida Species Invasive Fungal Infection Invasive Candidiasis Liver Transplant Recipient
Unable to display preview. Download preview PDF.
- 18.Walsh TJ, Hathorn JW, Sobel JD, et al (1991) Detection of circulating Candida enolase by immunoassay in patients with cancer and invasive candidiasis. N Engl J Med 324: 10261031Google Scholar
- 19.Edwards JE (2000) Candida species. In: Mandell GL, Bennett JE, Dolin R (eds) Principles and Practice of Infectious Diseases. Churchill Livingstone, New York, pp 2656–2673Google Scholar
- 26.Evans EGV (1975) The incidence of pathogenic yeast among open-heart surgery patients–the value of prophylaxis. J Thoracic Cardiovasc Surg 70: 466–470Google Scholar
- 29.Garbino J, Lew D, Romand J-A, Auckenthaler R, Suter P, Pittet D (1997) Fluconazole prevents severe Candida spp infections in high-risk critically ill patients: a randomized, double-blind, placebo-controlled study. In: Program and Abstracts of the 37`h Interscience Conference on Antimicrobial Agents and Chemotherapy. ASM Press, Herndon, pp LM-23bGoogle Scholar
- 32.Tollemar J, Hockerstedt K, Ericzon B-G, Jalanko H, Ringden 0 (1995) Liposomal amphotericin B prevents invasive fungal infections in liver transplant recipients: a randomized, placebo-controlled study. Transplantation 59: 45–50Google Scholar