title: Consensus statement on the management of invasive candidiasis in Intensive Care Units in the Asia-Pacific Region.
abstract: Invasive candidiasis has emerged as an important nosocomial infection, especially in critically ill patients. The incidence of candidaemia in Intensive Care Units (ICUs) is 5- to 10-fold higher than in the entire hospital and the crude mortality rate of patients with candidaemia is between 35% and 60%. Candida albicans remains the predominant cause of invasive candidiasis in ICUs, followed by Candida tropicalis, Candida glabrata and Candida parapsilosis. Invasive isolates of Candida spp. remain highly susceptible to fluconazole (>90% susceptible), although among Asia-Pacific countries the susceptibility rate of C. glabrata to fluconazole varies widely from 22% to 72%. Early diagnosis and prompt initiation of antifungal therapy are crucial for the effective treatment of invasive candidiasis. However, invasive candidiasis is difficult to diagnose owing to its non-specific clinical features, and delayed therapy is a major contributor to poor outcomes. Combining clinical risk factors with Candida colonisation parameters appears promising for guiding early interventions. Because of considerable regional variability, local epidemiological knowledge is critical in the effective management of invasive candidiasis among ICU patients in Asia-Pacific.
authors.affiliation: Departments of Laboratory Medicine and Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan. hsporen@ntu.edu.tw
authors.forename: Po-Ren
authors.initials: PR
authors.lastname: Hsueh
authors.forename: John Richard
authors.initials: JR
authors.lastname: Graybill
authors.forename: E Geoffrey
authors.initials: EG
authors.lastname: Playford
authors.forename: Siriorn Paritpokee
authors.initials: SP
authors.lastname: Watcharananan
authors.forename: Myoung-Don
authors.initials: MD
authors.lastname: Oh
authors.forename: Kamarudin
authors.initials: K
authors.lastname: Ja'alam
authors.forename: Shunwei
authors.initials: S
authors.lastname: Huang
authors.forename: Vivek
authors.initials: V
authors.lastname: Nangia
authors.forename: Asok
authors.initials: A
authors.lastname: Kurup
authors.forename: Alexander Angelo
authors.initials: AA
authors.lastname: Padiglione
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use; D001208:Asia / Q000453:epidemiology; D002177:Candidiasis / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D032921:Consensus; D015725:Fluconazole / Q000627:therapeutic use; D006801:Humans; D007362:Intensive Care Units; D010139:Pacific Islands / Q000453:epidemiology
chemical_list: D000935:Antifungal Agents; D015725:Fluconazole