Noppè Elnè, Eloff Julian Robert Paul, Keane Sean, Martin-Loeches Ignacio
Department of Intensive Care Medicine, Multidisciplinary Intensive Care Research Organization, (MICRO), St James' Hospital, Dublin, Ireland.
Department of Anaesthesia, Port Shepstone Regional Hospital, Port Shepstone, South Africa.
Ther Adv Pulm Crit Care Med. 2024 Dec 12;19:29768675241304684. doi: 10.1177/29768675241304684. eCollection 2024 Jan-Dec.
species is the most common cause of invasive fungal infection in the critically ill population admitted to the intensive care unit (ICU). Numerous risk factors for developing invasive candidiasis (IC) have been identified, and some, like the breach of protective barriers, abound within the ICU. Given that IC carries a significant mortality, morbidity, and healthcare cost burden, early diagnosis and treatment have become an essential topic of discussion. Several expert panels and task forces have been established to provide clear guidance on the management of IC. Unfortunately, IC remains a diagnostic and therapeutic challenge attributable to the changing fungal ecology of species and the emergence of multidrug-resistant strains. This narrative review will focus on the following: (1) the incidence, outcomes, and changing epidemiology of IC globally; (2) the risk factors for developing IC; (3) IC risk stratification tools and their appropriate use; (4) diagnosis of IC; and (5) therapeutic agents and regimens.
该菌种是入住重症监护病房（ICU）的重症患者侵袭性真菌感染的最常见原因。已确定了许多发生侵袭性念珠菌病（IC）的危险因素，其中一些，如保护屏障的破坏，在ICU中很常见。鉴于IC会带来重大的死亡率、发病率和医疗成本负担，早期诊断和治疗已成为一个重要的讨论话题。已经成立了几个专家小组和特别工作组，以提供关于IC管理的明确指导。不幸的是，由于该菌种真菌生态的变化和多重耐药菌株的出现，IC仍然是一个诊断和治疗挑战。本叙述性综述将重点关注以下方面：（1）全球IC的发病率、结局和不断变化的流行病学；（2）发生IC的危险因素；（3）IC风险分层工具及其合理使用；（4）IC的诊断；以及（5）治疗药物和方案。
