Intra-abdominal candidiasis: the guidelines—forgotten non-candidemic invasive candidiasis

Montravers, Philippe; Dupont, Hervé; Eggimann, Philippe

doi:10.1007/s00134-013-3134-2

Cited by 45 publications

(35 citation statements)

References 19 publications

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“…Since clinical signs of IAC are not specific and early microbiological documentation remains a major challenge, data regarding patients' outcome and predictors of mortality in IAC are still scarce [15]. Although abdominal candidiasis is still burdened by high mortality rates, current international guidelines mainly address candidemia.…”

Section: Discussionmentioning

confidence: 99%

A multicenter multinational study of abdominal candidiasis: epidemiology, outcomes and predictors of mortality

et al. 2015

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Section: Discussionmentioning

confidence: 99%

A multicenter multinational study of abdominal candidiasis: epidemiology, outcomes and predictors of mortality

et al. 2015

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“…Intraabdominal candidaisis (IAC) results from entry of C. albicans into the abdominal cavity through translocation across the GI mucosal barrier or by direct inoculation, which can occur via contaminated peritoneal dialysis catheters or as a result of perforation of the GI tract (85)(86)(87)(88) (Fig. 2C).…”

Section: Non-cd4mentioning

confidence: 99%

Candida albicans Pathogenesis: Fitting within the Host-Microbe Damage Response Framework

et al. 2016

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f Historically, the nature and extent of host damage by a microbe were considered highly dependent on virulence attributes of the microbe. However, it has become clear that disease is a complex outcome which can arise because of pathogen-mediated damage, host-mediated damage, or both, with active participation from the host microbiota. This awareness led to the formulation of the damage response framework (DRF), a revolutionary concept that defined microbial virulence as a function of host immunity. The DRF outlines six classifications of host damage outcomes based on the microbe and the strength of the immune response. In this review, we revisit this concept from the perspective of Candida albicans, a microbial pathogen uniquely adapted to its human host. This fungus commonly colonizes various anatomical sites without causing notable damage. However, depending on environmental conditions, a diverse array of diseases may occur, ranging from mucosal to invasive systemic infections resulting in microbe-mediated and/or host-mediated damage. Remarkably, C. albicans infections can fit into all six DRF classifications, depending on the anatomical site and associated host immune response. Here, we highlight some of these diverse and site-specific diseases and how they fit the DRF classifications, and we describe the animal models available to uncover pathogenic mechanisms and related host immune responses.

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“…Adapted from Montravers and colleagues. 17,18 Adaptations are themselves works protected by copyright. So in order to publish this adaptation, authorization must be obtained both from the owner of the copyright in the original work and from the owner of copyright in the translation or adaptation.…”

Section: Candida Dnamentioning

confidence: 99%

“…16 The pathophysiology of invasive candidiasis differs markedly between immunocompromised and critically ill patients. 17,18 In immunocompromised patients, prolonged neutropenia or functional impairment (transplanted patients) with eventual mucosal injuries resulting from chemotherapy, combined with the selective pressure of frequent and repeated exposure to antibacterial agents, result in a high prevalence of invasive candidiasis with a large proportion of bloodstream infections. In critically ill patients, other factors explain the high prevalence of invasive candidiasis.…”

Section: The Pathophysiology Of Invasive Candidiasismentioning

confidence: 99%

“…has no clinical significance. 17,23 However, colonization may progress to invasive candidiasis in recurrent peritonitis after anastomotic leakage. [24][25][26] In contrast to nonsurgical patients, these factors may explain why a high proportion of invasive candidiasis cases do not manifest with candidemia and develop only late in the course of the disease.…”

Section: The Pathophysiology Of Invasive Candidiasismentioning

confidence: 99%

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The Role of Biomarkers for Starting Antifungals in the Intensive Care Unit

Pagani

Revelly

Que

et al. 2015

Clinical Pulmonary Medicine

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Invasive candidiasis is associated with high mortality rates (35% to 60%), similar to the range reported for septic shock. The most common types include candidemia, frequently observed in immunocompromised patients, and noncandidemic systemic candidiasis, which constitutes the majority of cases in critically ill patients. However, they are difficult to prove and a definite diagnosis usually occurs late in the course of the disease, thus contributing to their bad prognosis. Early empirical treatment improves the prognosis and currently relies on the positive predictive value (PPV) of risk-assessment strategies (colonization index, Candida score, predictive rules) based on combinations of risk factors, but it may have also largely contributed to the overuse of antifungal agents in critically ill patients. In this context, nonculture-based diagnostic methods, including specific and nonspecific biomarkers, may significantly improve the diagnosis of invasive candidiasis. Candida DNA and mannan antigen/antimannan antibodies are of limited interest for the diagnosis of invasive candidiasis as they fail to identify noncandidemic systemic candidiasis, despite early positivity in candidemic patients. The utility of 1,3-beta-D-glucan (b-D-glucan), a panfungal cell wall antigen, has been demonstrated for the diagnosis of fungal infections in immunocompromised patients. Preliminary data suggest that it is also detectable early in critically ill patients developing noncandidemic systemic candidiasis. To take advantage of the high negative predictive value of risk-assessment strategies and the early increase in specific fungal biomarkers in high-risk patients, we propose a practical 2-step approach to improve the selection of patients susceptible to benefit from empirical antifungal treatment.

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Intra-abdominal candidiasis: the guidelines—forgotten non-candidemic invasive candidiasis

Cited by 45 publications

References 19 publications

A multicenter multinational study of abdominal candidiasis: epidemiology, outcomes and predictors of mortality

A multicenter multinational study of abdominal candidiasis: epidemiology, outcomes and predictors of mortality

Candida albicans Pathogenesis: Fitting within the Host-Microbe Damage Response Framework

The Role of Biomarkers for Starting Antifungals in the Intensive Care Unit

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