4f6c977748ecb3d1bbcc5d06c04aae88 pmc_9774599.pdf e838f754636a093574b0d4cc645a231af9e11358 pmc_9774599.pdf 6da577d495c8ff260c58451fd88db5c9a224daefc9808f1c570fc383aa0a143a pmc_9774599.pdf Title: How to Identify Invasive Candidemia in ICU—A Narrative Review Subject: The incidence of invasive fungal infection in ICUs has increased over time, and Candida spp. is the most common cause. Critical care patients are a particular set of patients with a higher risk of invasive fungal infections; this population is characterized by extensive use of medical devices such as central venous lines, arterial lines, bladder catheters, hemodialysis and mechanical intubation. Blood cultures are the gold standard diagnosis; still, they are not an early diagnostic technique. Mannan, anti-mannan antibody, 1,3–D-glucan, Candida albicans germ tube antibody, Vitek 2, PNA-FISH, MALDI-TOF, PCR and T2Candida panel are diagnostic promising microbiological assays. Scoring systems are tools to distinguish patients with low and high risk of infection. They can be combined with diagnostic tests to select patients for pre-emptive treatment or antifungal discontinuation. Candidemia is the focus of this narrative review, an approach to contributing factors and diagnosis, with an emphasis on critical care patients. Keywords: critical care patients; intensive care units; invasive fungal infection; candidemia Author: Joana Alves, Carles Alonso-Tarrés and Jordi Rello Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Wed Dec 14 02:09:27 2022 CET ModDate: Wed Dec 14 02:12:31 2022 CET Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 15 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 557555 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- TZTLZP+VnURWPalladioL Type 1 Custom yes yes no 10 0 LWLIVD+EURM10 Type 1 Builtin yes yes no 15 0 SAFMYW+URWPalladioL-Bold Type 1 Custom yes yes no 19 0 CLUCEH+URWPalladioL-Roma Type 1 Custom yes yes no 24 0 SUEYAS+URWPalladioL-Ital Type 1 Custom yes yes no 28 0 BTFGED+VnURWPalladioL-Bold Type 1 Custom yes yes no 32 0 YYFPCJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 51 0 CHJGZT+CMSY10 Type 1 Builtin yes yes no 79 0 ELAIKA+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 98 0 ELAIKC+PalatinoLinotype TrueType WinAnsi yes yes no 101 0 ELAIKE+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 104 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2023-12-12 02:34:08 CET RepresentationInformation: pmc_9774599.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2023-08-03 02:21:06 CEST Size: 557555 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 457 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Candidemia Risk Factors Destination: section.2 Children: Item: Title: Colonization and Infection Destination: subsection.2.1 Item: Title: Malignancy Destination: subsection.2.2 Item: Title: Surgery Destination: subsection.2.3 Item: Title: Catheter-Related Bloodstream Infection Destination: subsection.2.4 Item: Title: Sepsis Destination: subsection.2.5 Item: Title: Broad-Spectrum Antibiotics Destination: subsection.2.6 Item: Title: Diagnostic Approach Destination: section.3 Children: Item: Title: Culture Destination: subsection.3.1 Item: Title: Serum Biomarkers Destination: subsection.3.2 Item: Title: Molecular Biology Destination: subsection.3.3 Item: Title: Other Methods Destination: subsection.3.4 Item: Title: Scoring Systems Destination: section.4 Item: Title: Antifungal Stewardship Destination: section.5 Item: Title: Conclusions Destination: section.6 Item: Title: References Destination: section.6 Info: Title: How to Identify Invasive Candidemia in ICU A Narrative Review Author: Joana Alves, Carles Alonso-Tarrés and Jordi Rello Subject: The incidence of invasive fungal infection in ICUs has increased over time, and Candida spp. is the most common cause. Critical care patients are a particular set of patients with a higher risk of invasive fungal infections; this population is characterized by extensive use of medical devices such as central venous lines, arterial lines, bladder catheters, hemodialysis and mechanical intubation. Blood cultures are the gold standard diagnosis; still, they are not an early diagnostic technique. Mannan, anti-mannan antibody, 1,3 D-glucan, Candida albicans germ tube antibody, Vitek 2, PNA-FISH, MALDI-TOF, PCR and T2Candida panel are diagnostic promising microbiological assays. Scoring systems are tools to distinguish patients with low and high risk of infection. They can be combined with diagnostic tests to select patients for pre-emptive treatment or antifungal discontinuation. Candidemia is the focus of this narrative review, an approach to contributing factors and diagnosis, with an emphasis on critical care patients. 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