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To treat or not to treat – critically ill patients with candiduria
Author(s) -
Hollenbach Eike
Publication year - 2008
Publication title -
mycoses
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.13
H-Index - 69
eISSN - 1439-0507
pISSN - 0933-7407
DOI - 10.1111/j.1439-0507.2008.01570.x
Subject(s) - medicine , incidence (geometry) , critically ill , invasive candidiasis , intensive care medicine , fluconazole , urinary system , disease , candida albicans , intensive care , antifungal , dermatology , physics , biology , optics , genetics
Summary The prevalence of candiduria has increased in patients admitted to intensive care units (ICUs) and it has emerged as a common nosocomial infection among critically ill patients. Generally, urinary candidiasis should be regarded as a risk factor for invasive candidiasis, but not as a disease that needs to be treated on its own. However, decision‐making in critically ill patients with candiduria may become a balancing act, because candiduria may be the only indication for invasive candidaemia with significant morbidity and mortality. Of further concern, there is a worldwide increase in the incidence of non‐ albicans spp. isolated from urine with highly variable susceptibility to fluconazole, which has been the first‐line therapy for Candida infections during the last decades. This article discusses everyday problems with urinary candidiasis in interdisciplinary ICUs.