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Semin Respir Crit Care Med 2003; 24(1): 099-112
DOI: 10.1055/s-2003-37921
Copyright © 2002 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Candidiasis in the Intensive Care Unit

J. D. Sobel, J. Vazquez
  • Department of Internal Medicine, Detroit Medical Center, Wayne State University School of Medicine, Detroit, Michigan
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Publication History

Publication Date:
14 March 2003 (online)

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ABSTRACT

In the last 2 decades, Candida species have progressed from infrequent pathogens to among the most important and frequent opportunistic microorganisms causing nosocomial infection in intensive care unit (ICU) patients. Medical and surgical ICUs have become the epicenter of the Candida epidemic. Superficial infections causing oropharyngeal and esophageal candidiasis are common, and, although non-life threatening, may be refractory to conventional antifungals. In contrast, invasive candidiasis, candidemia, and hematogenous disseminated infections are associated with considerable attributable mortality. Although blood isolates of C. albicans remain susceptible to fluconazole, the increasing incidence of non-albicans Candida species with intrinsic reduced susceptibility to azoles creates new therapeutic challenges. Fortunately, lipid formulations of amphotericin B and the recently introduced echinocandin group represent new and strategic treatment responses to the challenge of invasive candidiasis.

KEYWORDS

ICU - Candida infections - candidiasis

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