To treat or not to treat--critically ill patients with candiduria.
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.
Hollenbach
Eike
E
Interdisciplinary Intensive Care Unit, Department of Medicine, University of Leipzig, Leipzig, Germany. eike.hollenbach@medizin.uni-leipzig.de
D000935:Antifungal Agents / Q000627:therapeutic use; D002175:Candida; D002177:Candidiasis / Q000175:diagnosis / Q000188:drug therapy*; D016638:Critical Illness; D003428:Cross Infection / Q000188:drug therapy; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D012307:Risk Factors; D014546:Urinary Catheterization / Q000009:adverse effects; D014552:Urinary Tract Infections / Q000175:diagnosis / Q000188:drug therapy*
D000935:Antifungal Agents