%0 Journal Article
%T Diagnosis of invasive candidiasis in the ICU
%A Philippe Eggimann
%A Jacques Bille
%A Oscar Marchetti
%J Annals of Intensive Care
%D 2011
%I Springer
%R 10.1186/2110-5820-1-37
%X Whereas in the past, opportunistic mycoses, such as Candida and Aspergillus, typically occurred in immunocompromised hosts, these complications are increasingly observed in nonimmunocompromised surgical and critically ill adult patients [1,2]. These trends were confirmed by a recent large international prevalence survey in ICUs, which reported infections due to Candida and Aspergillus in 17% and 1.4% patients, respectively [3].A large epidemiological survey in the United States reported a threefold increase of fungal sepsis during the period 1979-2000, and candidemia was reported to be the third most common cause of nosocomial bloodstream infection (BSI) in critically ill adult patients, representing 11% of all BSI [4,5]. The incidence of candidemia in U.S. hospitals during 2000-2005 increased from 3.65 to 5.56 episodes per 100,000 population [6]. Incidences are usually tenfold higher in the ICUs than in other wards: 3 to 15 episodes per 10,000 ICU patients-days or 2 to 10 cases per 1,000 ICU admissions are reported, with highest rates among surgical patients [1,7].Data from Europe have shown that the incidence of candidemia may be lower, with proportions ranging from 2-3% of bloodstream isolates [2,8]. A recent national surveillance, including 2,820 cases of fungemia in Denmark during the period 2004-2009, reported an increasing incidence from 7.7 to 8.6 per 100,000 [9]. Despite important regional differences, these data show that Candida is among the top ten bloodstream pathogens and suggest an increasing incidence of candidemia during the past 5 to 10 years.A large geographical variation of the proportions of the different Candida species has been reported (Table 1) [2,7-16]. In North and South America, non-albicans Candida species account for more than half of the bloodstream isolates: C. glabrata and C. parapsilosis are the predominant non-albicans species, respectively. Whereas in Europe, C. albicans remains the most frequent species, epidemiological trends su
%U http://www.annalsofintensivecare.com/content/1/1/37