Skip to main content

Epidemiology of Candida Infections in the Intensive Care Unit

North American Perspective

  • Chapter
Book cover Fungal Infection in the Intensive Care Unit

Part of the book series: Perspectives on Critical Care Infectious Diseases ((CCID,volume 6))

Abstract

Over the last two decades, the incidence of many fungal diseases in the United States has increased dramatically, mostly due to major advances in health care, as well as various demographic changes. These include aging of the population, the HIV epidemic, and the increasingly aggressive medical therapies available. Broad-spectrum antibiotics are more widely used than ever, especially among neutropenic and surgical patients in the intensive care unit (ICU). Potent cytotoxic chemotherapy, as well as more effective immunomodulation therapy, has resulted in prolonged survival of cancer patients and transplant recipients, but also in periods of severe immunosuppression and increased risk for fungal infections. Dramatic changes have also been achieved in neonatal care, leading to improved survival of premature infants.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Pinner RW, Teutsch SM, Simonsen Let al.Trends in infectious diseases mortality in the Unites States. JAMA 1996;275:189–93.

    Article  PubMed  CAS  Google Scholar 

  2. McNeil MM, Nash SL, Hajjeh RAet al.Trends in mortality due to invasive mycotic diseases in the United States, 1980–1997. Clin Infect Dis 2001; 33:641–7.

    Article  PubMed  CAS  Google Scholar 

  3. Simonsen L, Conn LA, Pinner RW, Teutsch S. Trends in infectious disease hospitalizations in the United States, 1980–1994. Arch Intern Med 1998;158:1923–8

    Article  PubMed  CAS  Google Scholar 

  4. Beck-Sague C, Jarvis WR. Secular trends in the epidemiology of nosocomial fungal infections in the United States, 1980–1990. National Nosocomial Infections Surveillance System. J Infect Dis 1993;167:1247–51.

    Article  CAS  Google Scholar 

  5. Pfaller MA, Jones RN, Messer SA, Edmond MB, Wenzel RP. National surveillance of nosocomial blood stream infection due toCandida albicans:frequency of occurrence and antifungal susceptibility in the SCOPE Program. Diagn Microbiol Infect Dis 1998;31:327–32.

    Article  PubMed  CAS  Google Scholar 

  6. Centers for Disease Control and Prevention. National nosocomial infections surveillance (NNIS) system report. Data summary from October 1986 - April 1998. Issued June 1998.http://www.cdc.govincidod/hip/NNIS/sar98net.PDF

  7. Centers for Disease Control and Prevention. National nosocomial infections surveillance (NNIS) system. Reported nosocomial infections, NNIS hospitals, 1975. Atlanta, GA: National Nosocomial Infection Study Report, 1977;1–7.

    Google Scholar 

  8. Pittet D, Tarara D, Wenzel RP. Nosocomial bloodstream infection in critically ill patients. Excess length of stay, extra costs, and attributable mortality. JAMA 1994;271:1598–601.

    Article  PubMed  CAS  Google Scholar 

  9. Fisher-Hoch SP, Hutwagner L. Opportunistic candidiasis: an epidemic of the 1980s. Clin Infect Dis 1995;21:897–904.

    Article  PubMed  CAS  Google Scholar 

  10. Wey SB, Mori M, Pfaller MA, Woolson RF, Wenzel RP. Hospital-acquired candidemia. The attributable mortality and excess length of stay. Arch Intern Med 1988;148:2642–5.

    Article  PubMed  CAS  Google Scholar 

  11. Banerjee SN, Emori TG, Culver DHet al.Secular trends in nosocomial primary bloodstream infections in the United States, 1980–1989. National Nosocomial Infections Surveillance System. Am J Med 1991;91:86S–89S.

    Article  PubMed  CAS  Google Scholar 

  12. Kao AS, Brandt ME, Pruitt WRet al.The epidemiology of candidemia in two United States cities: results of a population-based active surveillance. Clin Infect Dis 1999;29:1164–70.

    Article  PubMed  CAS  Google Scholar 

  13. Lyon GM, Ponce-de-Leon G, Sofair ANet al.Population-based surveillance for Candida bloodstream infections: trends in incidence of disease and azole resistance. In: Abstracts of the 40thInterscience Conference on Antimicrobial Agents and Chemotherapy. Washington DC, American Society for Microbiology, 2000; abstract 217, p.356.

    Google Scholar 

  14. Trick WE, Fridkin SK, Edwards JR, Gaynes RP. Trends in primary bloodstream infections associated withCandidaspp. in the United States. Abstracts of the 4thDecennial International Conference on Nosocomial and Healthcare-Associated Infections, 2000; abstract P-WI-02, p.219.

    Google Scholar 

  15. Yamamura DL, Rotstein C, Nicolle LE, Ioannou S. Candidemia at selected Canadian sites: results from the Fungal Disease Registry, 1992–1994. CMAJ 1999;160:493–9.

    PubMed  CAS  Google Scholar 

  16. Pfaller MA, Messer SA, Houston Aet al.National epidemiology of mycoses survey: a multicenter study of strain variation and antifungal susceptibility among isolates ofCandidaspecies. Diagn Microbiol Infect Dis 1998;31:289–96.

    Article  PubMed  CAS  Google Scholar 

  17. Man KA, Seidel K, White TC, Bowden RA. Candidemia in allogeneic blood and marrow transplant recipients: evolution of risk factors after the adoption of prophylactic fluconazole. J Infect Dis 2000;181:309–16.

    Google Scholar 

  18. Abi-Said D, Anaissie E, Uzun Oet al.The epidemiology of hematogenous candidiasis caused by different Candida species. Clin Infect Dis 1997;24:1122–8.

    Article  PubMed  CAS  Google Scholar 

  19. Kossoff EH, Buescher ES, Karlowicz MG. Candidemia in a neonatal intesive care unit: trends during fifteen years and clinical features of 111 cases. Pediatr Infect Dis J 1998;17:504–8.

    Article  PubMed  CAS  Google Scholar 

  20. Faix, RG. Invasive neonatal candidiasis: comparison of albicans and parapsilosis infection. Pediatr Infect Dis J 1992;11:88–93.

    Article  PubMed  CAS  Google Scholar 

  21. Levy I, Rubin LG, Vasishtha S, Tucci V, Sood SK. Emergence ofCandida parapsilosisas the predominant species causing candidemia in children. Clin Infect Dis 1998;26:1089–8.

    Article  Google Scholar 

  22. Whitehouse JD, Everts RJ, Hader SL, Goldberd RN, Kirkland KB. Epidemiology ofCandida parapsilosisbloodstream infections in a neonatal intensive care unit: a case-control study. Abstracts of the 9thAnnual Scientific Meeting of the Society for Healthcare Epidemiology of America, 1999.

    Google Scholar 

  23. Weese-Mayer DE, Fondriest DW, Brouillette RT, Shulman ST. Risk factors associated with candidemia in neonatal intensive care unit: a case-control study. Pediatr Infect Dis J 1987;6:190–6.

    Article  PubMed  CAS  Google Scholar 

  24. Weibel SF, McNeil MM, Kuyendall RJet al. Candida parapsilosisbloodstream infections in neonatal intensive care unit patients: epidemiologic and laboratory confirmation of a common source outbreak. Pediatr Infect Dis J 1996;15:998–1002.

    Article  Google Scholar 

  25. Sherertz RJ, Gledhill KS, Hampton KDet al.Outbreak of Candida bloodstream infections associated with retrograde medication administration in a neonatal intensive care unit. J Pediatr 1992;120:455–61.

    Article  PubMed  CAS  Google Scholar 

  26. Huang YC, Lin TY, Leu HSet al.Outbreak ofCandida parapsilosisfungemia in neonatal intensive care units: clinical implications and genotyping analysis. Infection 1999;27:97–102.

    Article  PubMed  CAS  Google Scholar 

  27. Rangel-Frausto MS, Wiblin T, Blumberg HMet al.National epidemiology of mycoses survey (NEMIS): variations in rates of bloodstream infections due toCandidaspecies in seven surgical intensive care units and six neonatal intensive care units. Clin Infect Dis 1999;29:253–8.

    Article  PubMed  CAS  Google Scholar 

  28. Ekenna O, Sherertz RJ, Bingham H. Natural history of bloodstream infections in a burn patient population: the importance of candidemia. Am J Infect Control 1993;21:189–95.

    Article  PubMed  CAS  Google Scholar 

  29. Odds FC. Candida and candidosis. 2ndedn. London: Bailliere Tindall, 1988.

    Google Scholar 

  30. Krause W, Matheis H, Wulf K. Fungaemia and funguria after oral administration ofCandida albicans.Lancet 1969;1:598–9.

    Article  PubMed  CAS  Google Scholar 

  31. Pfaller MA, Jones RN, Doern GVet al.International surveillance of bloodstream infections due toCandidaspecies: frequency of occurrence and antifungal susceptibilities of isolates collected in 1997 in the United States, Canada, and South America for the SENTRY Program. The SENTRY Participant Group. J Clin Microbiol 1998;36:1886–9.

    PubMed  CAS  Google Scholar 

  32. Benoit D, Decruyenaere J, Vandewoude Ket al.Management of candidal thrombophlebitis of the central veins: case report and review. Clin Infect Dis 1998;26:393–7.

    Article  PubMed  CAS  Google Scholar 

  33. Richet HM, Andremont A, Tancrede C, Pico JL, Jarvis WR. Risk factors for candidemia in patients with acute lymphocytic leukemia. Rev Infect Dis 1991;13:211–5.

    Article  PubMed  CAS  Google Scholar 

  34. Pittet D, Monod M, Suter PM, Frenk E, Auckenthaler R. Candida colonization and subsequent infections in critically ill surgical patients. Ann Surg 1994;220:751–8.

    Article  PubMed  CAS  Google Scholar 

  35. Solomon SL, Alexander H, Eley JW, et al. Nosocomial fungemia in neonates associated with intravascular pressure-monitoring devices. Pediatr Infect Dis 1986;5:680–5.

    Article  PubMed  CAS  Google Scholar 

  36. Solomon SL, Khabbaz RF, Parker RHet al.An outbreak ofCandida parapsilosisbloodstream infections in patients receiving parenteral nutrition. J Infect Dis 1984;149:98–102.

    Article  PubMed  CAS  Google Scholar 

  37. Weems JJ, Chamberland ME, Ward Jet al. Candida parapsilosisfungemia associated with parenteral nutrition and contaminated blood pressure transducers. J Clin Microbiol 1987;25:1029–32.

    PubMed  Google Scholar 

  38. Weems JJ.Candida parapsilosis:epidemiology, pathogenicity, clinical manifestations, and antimicrobial susceptibility Clin Infect Dis 1992;14:756–66.

    Article  PubMed  Google Scholar 

  39. Saiman L, Ludington E, Pfaller Met al.Risk factors for candidemia in neonatal intensive care unit patients. The National Epidemiology of Mycoses Survey study group. Pediatr Infect Dis J 2000;19:319–24.

    Article  PubMed  CAS  Google Scholar 

  40. Goodrich JM, Reed EC, Mori Met al.Clinical features and analysis of risk factors for invasive candidal infection after marrow transplantation. J Infect Dis 1991;164:731–40.

    Article  CAS  Google Scholar 

  41. Slavin MA, Osborne B, Adams Ret al.Efficacy and safety of fluconazole prophylaxis for fungal infections after marrow transplantation-a prospective, randomized, double-blind study. J Infect Dis 1995;171:1545–52.

    Article  PubMed  CAS  Google Scholar 

  42. Anaissie EJ, Rex JH, Uzun O, Vartivarian S. Predictors of adverse outcome in cancer patients with candidemia. Am J Med 1998;104:238–45.

    Article  PubMed  CAS  Google Scholar 

  43. Marshall JC, Christou NV, Horn R, Meakins JL. The microbiology of multiple organ failure. The proximal gastrointestinal tract as an occult reservoir of pathogens. Arch Surg 1988;123:309–15.

    Article  PubMed  CAS  Google Scholar 

  44. Voss A, le Noble JL, Verduyn Lunel FM, Foudraine NA, Meis JF. Candidemia in intensive care unit patients: risk factors for mortality. Infection 1997;25:8–11.

    Article  PubMed  CAS  Google Scholar 

  45. King MD, Blumberg HM, Soucie Met al.Mortality due to Candida bloodstream infections in the surgical intensive care unit. In: Abstracts of the 37thIDSA Conference, 1999; abstract 289, p.90.

    Google Scholar 

  46. Huttova M, Hartmanova I, Kralinsky Ket al.Candida fungemia in neonates treated with fluconazole: report of forty cases, including eight with meningitis. Pediatr Infect Dis J 1998;17:1012–5.

    Article  PubMed  CAS  Google Scholar 

  47. Mittal M, Dhanireddy R, Higgins RD. Candida sepsis and association with retinopathy of prematurity. Pediatrics 1998;101:654–7.

    Article  PubMed  CAS  Google Scholar 

  48. Rentz AM, Halpern MT, Bowden R. The impact of candidemia on length of hospital stay, outcome, and overall cost of illness. Clin Infect Dis 1998;27:781–8.

    Article  PubMed  CAS  Google Scholar 

  49. Goodman JL, Winston DJ, Greenfield RAet al.A controlled trial of fluconazole to prevent fungal infections in patients undergoing bone marrow transplantation N Engl J Med 1992;326:845–51.

    Article  PubMed  CAS  Google Scholar 

  50. Rex JH, Walsh TJ, Sobel JDet al.Practice guidelines for the treatment of candidiasis. Infectious Diseases Society of America. Clin Infect Dis 2000;30:662–78.

    Article  PubMed  CAS  Google Scholar 

  51. Eggimann P, Francioli P, Bille Jet al.Fluconazole prophylaxis prevents intra-abdominal candidiasis in high-risk surgical patients Crit Care Med 1999;27:1066–72.

    Article  PubMed  CAS  Google Scholar 

  52. Pelz RK, Hendrix CW, Swoboda SMet al.Double-blind placebo-controlled trial of fluconazole to prevent candida! infections in critically ill surgical patients. Ann Surg 2001;233:542–8.

    Article  PubMed  CAS  Google Scholar 

  53. Reiss E, Tanaka K, Bruker Get al.Molecular diagnosis and epidemiology of fungal infections. Med Mycol 1998;36(Suppl 1):249–57.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2002 Springer Science+Business Media New York

About this chapter

Cite this chapter

Hajjeh, R.A., Lyon, G.M. (2002). Epidemiology of Candida Infections in the Intensive Care Unit. In: Barnes, R.A., Warnock, D.W. (eds) Fungal Infection in the Intensive Care Unit. Perspectives on Critical Care Infectious Diseases, vol 6. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-0977-6_1

Download citation

  • DOI: https://doi.org/10.1007/978-1-4615-0977-6_1

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4613-5333-1

  • Online ISBN: 978-1-4615-0977-6

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics