Impact of <i>Candida</i> Species on Clinical Outcomes in Patients with Suspected Ventilator‐Associated Pneumonia

Delisle, Marie-Soleil; Williamson, David; Albert, Martin; Perreault, Marc M.; Jiang, Xuran; Day, Andrew G.; Heyland, Daren K.

doi:10.1155/2011/827692

Cited by 52 publications

(37 citation statements)

References 37 publications

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“…is not definitely an innocent bystander in the respiratory tract of ICU ventilated patients [3][4][5][6][7][8][9][10][11][12][13] (Table 1). Beta-glucan (BG), a component of yeast cell wall, may act as a lung proinflammatory agent causing alveolar macrophage and neutrophil dysfunction.…”

mentioning

confidence: 99%

“…Live Candida albicans instillation in rats has been observed to increase the susceptibility to develop experimental Pseudomonas aeruginosa (PA), Escherichia coli (Ec), and Staphylococcus aureus (Sa) pneumonia, fostering the production of lung inflammatory cytokines (tumor necrosis factor alpha [TNF-alpha], interleukin-6 [IL-6], and interferon-gamma [INF-c]) and inhibiting alveolar macrophage phagocytosis [3,5]. From a clinical viewpoint, Candida airway colonization has been shown to be associated with prolonged duration of mechanical ventilation, ICU/hospital length of stay, and increased mortality [8][9][10][11]. One of the first reports of this possible relationship dates back to almost 10 years ago, when Azoulay et al [6] identified Candida bronchial isolation as an independent risk factor for the development of PA ventilator-associated pneumonia (VAP) (9 vs 4.8 % in non-colonized patients, p = 0.048).…”

mentioning

confidence: 99%

“…The authors previously described that patients with RT Candida colonization and csVAP may experience similar inflammation burden and worse outcome than patients with bacterial infections [11]. Airway Candida colonization is associated with pulmonary inflammation and consequent cellular immune dysfunction, but the role of biofilm and fungal-bacterial cross-talk should not be neglected.…”

mentioning

confidence: 99%

“…BG positivity was associated with increased 28-day mortality (p = 0.03) Delisle et al [11] Retrospective exploratory analysis 274 pts (68 with Cc RT/VAP) Candida spp. was associated with increased hospital mortality (p \ 0.001) Hamet et al [12] Prospective observational study 323 pts (181 with Cc RT/csVAP) CC RT was an independent risk factor for MDR bacteria isolation (OR 1.79, 95 % CI 1.05-3.05, p = 0.03) Ong et al [13] Observational cohort study 333 episodes of RT Cc episodes (59 received NAB)…”

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confidence: 99%

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Candida colonization of respiratory tract: to treat or not to treat, will we ever get an answer?

Pascale

Antonelli

2014

Intensive Care Med

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confidence: 99%

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confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Candida colonization of respiratory tract: to treat or not to treat, will we ever get an answer?

Pascale

Antonelli

2014

Intensive Care Med

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“…According to the EORTC/MSG definitions of IFD, fever is not a host factor, and due to the lack of specificity is only considered a clinical sign [41]. However, persistent fever, in particular when antibiotics are used ineffectively, can often suggest a fungal infection [41,42]. In such case, if clinical signs and host factors are present, without the conformation in mycological tests, the criteria of possible IFD are fulfilled.…”

Section: Diagnostic Methods To Prove Fungal Infectionmentioning

confidence: 99%

Early diagnosis and treatment of invasive aspergillosis as a main determinant of outcome – review of literature according to the presented case report

Borys¹,

Piwowarczyk²,

Sysiak³

et al. 2017

Ann Agric Environ Med.

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Although. Aspergillus spp infection is not the major cause of morbidity in Intensive Care Units (ICUs), mortality among patients treated for it is tremendous. Moreover, invasive aspergillosis (IA) is an independent risk factor of hospital costs and length of stay. The prevalence of this disease is inversely correlated with the immunocompetence of individuals; for instance, the incidence of IA among patients with leukemia is estimated as high as 12.7%. Although there is a significant improvement in the antifungal armamentarium, the appropriate treatment is still being given too late, mostly because of late diagnosis. As well as the diagnosis, the criteria for recognition of IA constitute a challenge. Objective. The aim of this review, based on a case report, is to introduce the problem of poor diagnosis and treatment of IA, especially in the critical care settings. The presented scenario is an example which assists in showing the evidence-based medicine (EBM) approach to the treatment of fungal infections. Furthermore, to demonstrate the appropriate approach to diagnosis and treatment of invasive aspergillosis, the guidelines of The European Organization for Research and Treatment of Cancer/Mycoses Study Group (EORTC/MSG) are presented. Conclusions. According to presented literature, Galactomannan assay enables early diagnosis and remains a specific and sensitive tool to diagnose Asppergillosis, both in serum and BAL fluid. The guidelines recommend voriconazole as a first line treatment in IA. Failure to detect and implement proper antifungal treatment may lead to fatal consequences, as in the presented case.

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Phase 3 Pilot Randomized Controlled Trial Comparing Early Trophic Enteral Nutrition With “No Enteral Nutrition” in Mechanically Ventilated Patients With Septic Shock

Patel

Kozeniecki

Peppard

et al. 2019

J Parenter Enteral Nutr

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BackgroundThe optimal dose and timing of enteral nutrition (EN) in septic shock are unclear.MethodsWe conducted a phase 3 single‐center randomized controlled pilot trial comparing early trophic EN with “no EN” in mechanically ventilated adults with septic shock, with the hypothesis that implementing a protocol comparing early trophic EN with “no EN” in patients with septic shock would be feasible. Patients were randomized to early trophic EN or “no EN” until off vasopressor for 3 hours. The primary outcome was feasibility in achieving >75% consent and compliance rate and <10% contamination rate.ResultsOne hundred thirty‐one patients were eligible for enrollment, and 49 were available for consent. Thirty‐one (86%) consented and were randomized and 100% of patients in the early EN arm and 94% in the “no EN” arm completed their protocols. While on vasopressors, early EN group received median 384 kcal, and the “no EN” group received median 0 kcal. Contamination rate was 0 in the early trophic EN arm and 6% in the “no EN” arm. The early EN group had median 25 intensive care unit–free days, as compared with 12 in the “no EN” arm (P = .014). The early EN arm had median 27 ventilator‐free days, compared with 14 in “no EN” arm (P = .009).ConclusionOur protocol comparing early trophic EN with “no EN” in septic shock was feasible. Early trophic EN may be beneficial, but a larger multicenter trial is warranted to confirm the observed clinical benefits seen in this trial.

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Impact of Candida Species on Clinical Outcomes in Patients with Suspected Ventilator‐Associated Pneumonia

Cited by 52 publications

References 37 publications

Candida colonization of respiratory tract: to treat or not to treat, will we ever get an answer?

Candida colonization of respiratory tract: to treat or not to treat, will we ever get an answer?

Early diagnosis and treatment of invasive aspergillosis as a main determinant of outcome – review of literature according to the presented case report

Phase 3 Pilot Randomized Controlled Trial Comparing Early Trophic Enteral Nutrition With “No Enteral Nutrition” in Mechanically Ventilated Patients With Septic Shock

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