C M Chalmers1, A M Bal. 1. Department of Anaesthesia, Crosshouse Hospital, Kilmarnock KA2 0BE, UK. kitchalmers@doctors.org.uk
Abstract
BACKGROUND: Candida species are a common cause of nosocomial bloodstream infection. Such infections commonly affect patients in the intensive care unit (ICU) and carry a high mortality. There are published guidelines for the management of fungal infections, but there are no data on the usual management of invasive Candida infections in UK ICUs. METHODS: An electronic survey was sent by email to a representative clinician in 236 ICUs, over 90% of units in the UK. Questions related to the institution of empirical therapy and to the management of proven candidaemia. RESULTS: There were 72 responses. A minority of units follow a policy regarding the management of these infections but the involvement of microbiologists is usual. Empirical therapy is used in 85.9% of units, often for patients perceived to be at high risk. Fluconazole is the most commonly used antifungal agent, both for empirical therapy and for the treatment of proven candidaemia. For candidaemic patients, 73.9% of ICUs frequently or always remove central venous catheters within 48 h, while 15.1% frequently or always arrange ophthalmology review. CONCLUSIONS: Management of fungal infections is relatively consistent among responding units. However, recent developments in the field have not yet been incorporated into standard practice. Adherence to published guidelines could be improved, potentially reducing morbidity and mortality from these common infections.
BACKGROUND: Candida species are a common cause of nosocomial bloodstream infection. Such infections commonly affect patients in the intensive care unit (ICU) and carry a high mortality. There are published guidelines for the management of fungal infections, but there are no data on the usual management of invasive Candida infections in UK ICUs. METHODS: An electronic survey was sent by email to a representative clinician in 236 ICUs, over 90% of units in the UK. Questions related to the institution of empirical therapy and to the management of proven candidaemia. RESULTS: There were 72 responses. A minority of units follow a policy regarding the management of these infections but the involvement of microbiologists is usual. Empirical therapy is used in 85.9% of units, often for patients perceived to be at high risk. Fluconazole is the most commonly used antifungal agent, both for empirical therapy and for the treatment of proven candidaemia. For candidaemic patients, 73.9% of ICUs frequently or always remove central venous catheters within 48 h, while 15.1% frequently or always arrange ophthalmology review. CONCLUSIONS: Management of fungal infections is relatively consistent among responding units. However, recent developments in the field have not yet been incorporated into standard practice. Adherence to published guidelines could be improved, potentially reducing morbidity and mortality from these common infections.
Authors: M T Montagna; G Caggiano; G Lovero; O De Giglio; C Coretti; T Cuna; R Iatta; M Giglio; L Dalfino; F Bruno; F Puntillo Journal: Infection Date: 2013-03-06 Impact factor: 3.553
Authors: Sidi Mohammed Lahbib Seddiki; Zahia Boucherit-Otmani; Kebir Boucherit; Souad Badsi-Amir; Mourad Taleb; Dennis Kunkel Journal: Int J Gen Med Date: 2013-01-09
Authors: Gerardo Aguilar; Carlos Delgado; Isabel Corrales; Ana Izquierdo; Estefanía Gracia; Tania Moreno; Esther Romero; Carlos Ferrando; José A Carbonell; Rafael Borrás; David Navarro; F Javier Belda Journal: BMC Res Notes Date: 2015-09-29