Occurrence, presentation and treatment of candidemia

Abstract

Candida is one of the most common causes of nosocomial bloodstream infections. Candidemia is not confined to hematological patients, intensive care units or abdominal surgery wards, but it is remarkably frequent in the internal medicine setting. High mortality associated with candidemia can be reduced by prompt, appropriate antifungal therapy. The epidemiology of species has been shifting toward non-albicans strains. Significant improvements in nonculture-based diagnostic methods, such as serological markers, have been made in recent years, and novel diagnostic techniques should be further studied to enable early pre-emptive therapy. Treatment guidelines indicate that echinocandins are at present the best choice for patients who are severely ill or possibly infected with fluconazole-resistant strains.

Keywords::

• (1,3)-β-d-glucan
• Candida
• echinocandin
• mannan
• mortality
• non-albicans
• pre-emptive therapy

Financial & competing interests disclosure

C Viscoli has served on speakers’ bureaus and on advisory boards for Astellas, Gilead, MSD and Pfizer. M Mikulska has served on advisory boards for MSD and Pfizer. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.