tailieunhanh - báo cáo hóa học: " Diagnosis of invasive candidiasis in the ICU"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành hóa học dành cho các bạn yêu hóa học tham khảo đề tài: Diagnosis of invasive candidiasis in the ICU | Eggimann et al. Annals of Intensive Care 2011 1 37 http content 1 1 37 Ù Annals of Intensive Care a SpringerOpen Journal REVIEW Open Access Diagnosis of invasive candidiasis in the ICU Philippe Eggimann 1 Jacques Bille2 and Oscar Marchetti3 Abstract Invasive candidiasis ranges from 5 to 10 cases per 1 000 ICU admissions and represents 5 to 10 of all ICU-acquired infections with an overall mortality comparable to that of severe sepsis septic shock. A large majority of them are due to Candida albicans but the proportion of strains with decreased sensitivity or resistance to fluconazole is increasingly reported. A high proportion of ICU patients become colonized but only 5 to 30 of them develop an invasive infection. Progressive colonization and major abdominal surgery are common risk factors but invasive candidiasis is difficult to predict and early diagnosis remains a major challenge. Indeed blood cultures are positive in a minority of cases and often late in the course of infection. New nonculture-based laboratory techniques may contribute to early diagnosis and management of invasive candidiasis. Both serologic mannan antimannan and betaglucan and molecular Candida-specific PCR in blood and serum have been applied as serial screening procedures in high-risk patients. However although reasonably sensitive and specific these techniques are largely investigational and their clinical usefulness remains to be established. Identification of patients susceptible to benefit from empirical antifungal treatment remains challenging but it is mandatory to avoid antifungal overuse in critically ill patients. Growing evidence suggests that monitoring the dynamic of Candida colonization in surgical patients and prediction rules based on combined risk factors may be used to identify ICU patients at high risk of invasive candidiasis susceptible to benefit from prophylaxis or preemptive antifungal treatment. Epidemiology of invasive candidiasis Whereas