title: Invasive candidiasis in intensive care unit; consensus statement from an Iranian panel of experts, July 2013.
abstract: Invasive candidiasis (IC) is associated with high mortality in intensive care unit (ICU) patients. Timely diagnosis of this potentially fatal condition remains a challenge; on the other hand, the criteria for initiating empirical antifungal therapy in critically ill patients are not well defined in different patient population and ICU settings. Alongside the international guidelines, reaching regional and local consensus on diagnosis and management of IC in ICU setting is essential. This report summarizes our present status of IC management in ICU, considered by a group of Iranian experts in the fields of intensive care and infectious diseases. A round table of 17 experts was held to review the available data and discuss the optimal treatment strategies for IC in critical care setting. Comparative published data on the management of IC were analytically reviewed and the commonly asked questions about the management of IC in ICU were isolated. These questions were interactively discussed by the panel and audience responses were taken to consolidate point-to-point agreement with the panel arriving at consensus in many instances. The responses indicated that patients' risk stratification, clinical discretion, fungal diagnostic techniques and the empirical therapy for IC are likely to save more patients. Treatment options were recommended to be based on the disease severity, prior azole exposure, and the presence of suspected azole-resistant Candida species. This report was reviewed, edited and discussed by all participants to include further evidence-based insights. The panel expects such endorsed recommendations to be soon formulated for implementation across the country.
authors: Department of Anesthesiology and Critical Care, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors: Arezoo
authors: A
authors: Ahmadi
authors: Department of Anesthesiology and Critical Care, Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors: Seyed Hossein
authors: SH
authors: Ardehali
authors: Department of Anesthesiology and Critical Care, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors: Mohammad Taghi
authors: MT
authors: Beigmohammadi
authors: Department of Infectious Diseases, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors: Mahboubeh
authors: M
authors: Hajiabdolbaghi
authors: Department of Anesthesiology and Critical Care, Masih-Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors: Seyed Mohammad Reza
authors: SM
authors: Hashemian
authors: Department of Anesthesiology and Critical Care, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors: Mehran
authors: M
authors: Kouchek
authors: Department of Infectious Diseases, Rasoul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
authors: Ali
authors: A
authors: Majidpour
authors: Department of Internal Medicine, Division of Pulmonology, Critical Care Unit, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors: Majid
authors: M
authors: Mokhtari
authors: Department of Anesthesiology and Critical Care, Rasoul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
authors: Omid Moradi
authors: OM
authors: Moghaddam
authors: Department of Anesthesiology and Critical Care, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors: Atabak
authors: A
authors: Najafi
authors: Department of Anesthesiology and Critical Care, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors: Reza
authors: R
authors: Nejat
authors: Department of Anesthesiology and Critical Care, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors: Mohammad
authors: M
authors: Niakan
authors: Intensive Care Unit, Laleh Hospital, Tehran, Iran.
authors: Amir Hossein
authors: AH
authors: Lotfi
authors: Iranian Society of Anesthesiology and Critical Care, Tehran, Iran.
authors: Ali
authors: A
authors: Amirsavadkouhi
authors: Intensive Care Unit, Vali-e-Asr Hospital, NAJA University, Tehran, Iran.
authors: Farzad
authors: F
authors: Shirazian
authors: Department of Infectious Diseases, Masih-Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors: Payam
authors: P
authors: Tabarsi
authors: Department of Infectious Diseases, Rasoul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
authors: Mahshid Talebi
authors: MT
authors: Taher
authors: Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran ; Behphar Scientific Committee, Behphar Group, Tehran, Iran.
authors: Mohammad
authors: M
authors: Torabi-Nami
keywords: Iran; intensive care unit; invasive candidiasis; local consensus; therapy