Bajwa Sj, Kulshrestha A
Department of Anaesthesiology and Intensive Care, Gian Sagar Medical College and Hospital, Ram Nagar, Banur, Punjab, India.
Ann Med Health Sci Res. 2013 Apr;3(2):238-44. doi: 10.4103/2141-9248.113669.
Infections have almost become an inseparable part of the intensive care units throughout the globe in spite of numerous advancements in diagnostic and therapeutic interventions. With advances in critical care medicine and introduction of broad-spectrum antibiotics, the incidence of invasive fungal infections in intensive care is on the rise, especially in patients with immunosuppression. The aim of this review is to collect recent information about various types of invasive fungal infections prevalent in the intensive care unit, the problems in their diagnosis and recent trends in their management. A thorough literature search was made in PubMed and Google using the following keywords for our search: Invasive fungal infection, antifungal therapy in intensive care unit, candidiasis. The major fungi implicated worldwide are Candida and Aspergillus spp., followed by Cryptococcus, Histoplasma, etc., in endemic areas. These produce a wide variety of infections that are difficult to diagnose as most of the diagnosing tests are non-specific and the culture takes a long time. An early suspicion of fungal infection with institution of appropriate antifungal therapy is mandatory for a positive outcome and to prevent development of invasive fungal infection.
尽管在诊断和治疗干预方面取得了诸多进展，但感染几乎已成为全球重症监护病房中不可分割的一部分。随着重症医学的进步以及广谱抗生素的引入，重症监护中侵袭性真菌感染的发生率正在上升，尤其是在免疫抑制患者中。本综述的目的是收集有关重症监护病房中普遍存在的各种侵袭性真菌感染的最新信息、其诊断中的问题以及管理方面的最新趋势。我们在PubMed和谷歌上进行了全面的文献检索，使用以下关键词进行搜索：侵袭性真菌感染、重症监护病房中的抗真菌治疗、念珠菌病。在全球范围内，主要涉及的真菌是念珠菌属和曲霉属，在流行地区其次是隐球菌属、组织胞浆菌属等。这些真菌会引发多种感染，由于大多数诊断测试不具有特异性且培养需要很长时间，因此难以诊断。早期怀疑真菌感染并开始适当的抗真菌治疗对于取得阳性结果和预防侵袭性真菌感染的发展至关重要。
