Epelbaum Oleg, Chasan Rachel
Division of Pulmonary, Critical Care, and Sleep Medicine, Westchester Medical Center, New York Medical College, 100 Woods Road, Macy Pavilion Room 1042, Valhalla, NY 10595, USA.
Division of Infectious Diseases, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1090, New York, NY 10029, USA.
Clin Chest Med. 2017 Sep;38(3):493-509. doi: 10.1016/j.ccm.2017.04.010. Epub 2017 Jun 16.
Candidemia presents several challenges to the intensive care unit (ICU) community. Recognition and treatment of this infection is frequently delayed, with dramatic clinical deterioration and death often preceding the detection of Candida in blood cultures. Identification of individual patients at the highest risk for developing candidemia remains an imperfect science; the role of antifungal therapy before culture diagnosis is yet to be fully defined in the ICU. The absence of well-established molecular techniques for early detection of candidemia hinders efforts to reduce the heavy clinical and economic impact of this infection. Echinocandins are the recommended antifungal drug class for the treatment of ICU candidemia.
念珠菌血症给重症监护病房（ICU）群体带来了诸多挑战。这种感染的识别和治疗常常延迟，在血培养中检测到念珠菌之前，往往就会出现显著的临床恶化和死亡。确定发生念珠菌血症风险最高的个体患者仍是一门不完善的科学；在ICU中，培养诊断前抗真菌治疗的作用尚未完全明确。缺乏成熟的早期检测念珠菌血症的分子技术，阻碍了减轻这种感染沉重临床和经济影响的努力。棘白菌素是治疗ICU念珠菌血症推荐使用的抗真菌药物类别。
