How to Identify Invasive Candidemia in ICU—A Narrative Review

Alves, Joana; Alonso-Tarrés, Carles; Rello, Jordi

doi:10.3390/antibiotics11121804

Cited by 16 publications

(10 citation statements)

References 94 publications

(155 reference statements)

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“…In our study, C. orthopsilosis has been misidentified as C. parapsilosis or C. famata by biochemical identification, whereas a mass spectrometry met the daily needs of clinicians as a reliable, cost- and time-effective platform for detection of C. orthopsilosis via blood cultures from the ICU patient [ 30 , 31 ]. C. orthopsilosis and C. parapsilosis shared the epidemiological relationship at ICU; therefore, intraspecies identification with sequencing and matching of ITS region was essential [ 22 , 23 , 32 ]. The high ITS homology between C. orthopsilosis isolated from blood, central line collected blood, and central line catheter, after its removal at the same timepoint, was indicated.…”

Section: Discussionmentioning

confidence: 99%

Molecular Investigation of the Fatal Bloodstream Candida orthopsilosis Infection Case following Gastrectomy

Mnichowska-Polanowska

Adamowicz

Wojciechowska‐Koszko

et al. 2023

IJMS

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Candida orthopsilosis represents a closely related cryptic genospecies of Candida parapsilosis complex-misidentified in routine diagnostic assays. This is emerging in settings where central venous catheters, invasive medical interventions, and echinocandin treatments are most likely to be used. A 59-year-old, non-neutropenic male patient, was admitted to an intensive care unit (ICU) due to respiratory distress syndrome, following a partial gastrectomy. As a result of duodenal stump leakage, re-laparotomy was required, abdominal drains were provided and central line catheters were exchanged. Multiple isolates of Candida orthopsilosis drawn from consecutive blood cultures were identified, despite ongoing echinocandin therapy and confirmed in vitro echinocandins susceptibility of the isolated strain. Species identification was verified via ITS region sequencing. Herein, we report the well-documented—per clinical data and relevant laboratory diagnosis—first case of a bloodstream infection caused by Candida orthopsilosis in Poland.

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Section: Discussionmentioning

confidence: 99%

Molecular Investigation of the Fatal Bloodstream Candida orthopsilosis Infection Case following Gastrectomy

Mnichowska-Polanowska

Adamowicz

Wojciechowska‐Koszko

et al. 2023

IJMS

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“…Considering blood culture to be the gold standard for IC diagnosis 19 the sensitivity and specificity of CAGTA and PCR were calculated as shown in table 3. The overall sensitivity is greater than either alone but the specificity is less than either alone.…”

Section: Polymerase Chain Reaction For Detection Of Calb Genementioning

confidence: 99%

Role of Candida Albicans Germ Tube Antibody Test in Diagnosis of Invasive Candidiasis in Intensive Care Unit at Beni-Suef University Hospital

Kamel,

Morsy,

Azmy

et al. 2024

Egyptian Journal of Medical Microbiology

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Background: Candida species are common human commensals can cause wide range of ailments. The most serious is a spread serious infection, which happens with expanded pervasiveness in emergency unit patients. Authoritative diagnosis relies upon isolation of Candida from blood culture or positive cultures from other normally sterile body sites, yet this may recognize less than half of cases. Improved diagnostics are expected to control inception of antifungal treatment to diminish mortality rate. Objective: The aim of this study was to evaluate the potential utility of the CALB gene recognition PCR and the Candida albicans germ tube antibody test (CAGTA) as biomarkers for quickly identifying invasive candidiasis in patients who were in danger of developing the disease in emergency departments. Methodology: The study included 50 patients from ICU suffering from invasive Candida infection. For all patients, blood culture, CAGTA test and PCR for identification of CALB gene were done. Results: Taking blood culture as the gold standard for diagnosis of invasive candidiasis. The sensitivity of CAGT was 75% and the specificity was 88.1% while the sensitivity of PCR was 100% and the specificity was 83.3%. Conclusion: For the diagnosis of an invasive candida infection, the biomarkers PCR and CAGT have additional value.

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“…Several factors have been associated with the risk of candidemia in prolonged hospital stays in ICU patients, including using a catheter, total parenteral nutrition, systemic broad-spectrum antibiotic usage, Candida colonization history, history of surgery and being in immunosuppressive therapy. Moreover, underlying factors include immunocompromised persons with co-morbidities such as malignancy and hematological disorders, premature infants and low-birth-weight neonates; solid organ transplantation, neutropenia, extensive burns and renal dysfunction have also been reported as predispositions to CBSI [3] , [12] , [13] , [16] .…”

Section: Catheter-associated Candida Biofilmsmentioning

confidence: 99%

“…Candida bloodstream infection (CBSI) associated with catheter use has a high mortality rate, particularly in prolonged hospital stays in intensive care unit (ICU) patients [3] , [12] , [13] . The main culprit of CBSI related to catheter use is microbial biofilm formation [1] , [14] , [15] .…”

Section: Introductionmentioning

confidence: 99%

Biofilm: The invisible culprit in catheter-induced candidemia

2023

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<abstract> <p>Candidemia is the most common form of invasive fungal infection associated with several risk factors, and one of them is the use of medical devices, to which microbial biofilms can attach. Candidemia related to the use of peripheral intravascular and central venous catheters (CVC) is referred to as <italic>Candida</italic> catheter-related bloodstream infection, with more than 90% being related to CVC usage. The infection is associated with a higher morbidity and mortality rate than nosocomial bacterial infections. <italic>Candida</italic> spp. can protect themselves from the host immune system and antifungal drugs because of the biofilm structure, which is potentiated by the extracellular matrix (ECM). <italic>Candida albicans</italic> and <italic>Candida parapsilosis</italic> are the most pathogenic species often found to form biofilms associated with catheter usage. Biofilm formation of <italic>C. albicans</italic> includes four mechanisms: attachment, morphogenesis, maturation and dispersion. The biofilms formed between <italic>C. albicans</italic> and non-albicans spp. differ in ECM structure and composition and are associated with the persistence of colonization to infection for various catheter materials and antifungal resistance. Efforts to combat <italic>Candida</italic> spp. biofilm formation on catheters are still challenging because not all patients, especially those who are critically ill, can be recommended for catheter removal; also to be considered are the characteristics of the biofilm itself, which readily colonizes the permanent medical devices used. The limited choice and increasing systemic antifungal resistance also make treating it more difficult. Hence, alternative strategies have been developed to manage <italic>Candida</italic> biofilm. Current options for prevention or therapy in combination with systemic antifungal medications include lock therapy, catheter coating, natural peptide products and photodynamic inactivation.</p> </abstract>

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How to Identify Invasive Candidemia in ICU—A Narrative Review

Cited by 16 publications

References 94 publications

Molecular Investigation of the Fatal Bloodstream Candida orthopsilosis Infection Case following Gastrectomy

Molecular Investigation of the Fatal Bloodstream Candida orthopsilosis Infection Case following Gastrectomy

Role of Candida Albicans Germ Tube Antibody Test in Diagnosis of Invasive Candidiasis in Intensive Care Unit at Beni-Suef University Hospital

Biofilm: The invisible culprit in catheter-induced candidemia

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