title: [Update on invasive candidiasis in non-neutropenic critically ill adult patients].
abstract: Invasive candidiasis in non-neutropenic critically ill patients remains a challenge for clinicians due to its association with high morbidity and mortality rates, increased incidence, and health-care costs. It is well known that early diagnosis and treatment are associated with a better prognosis. For these reasons a thorough update has been performed in this setting focused on recent Spanish epidemiology, new predictive scores and microbiological tests such as mannan antigen, mannan antibodies, Candida albicans germ-tube antibodies or (1→3)-β-D-glucan detection, molecular techniques for the detection of fungal-specific DNA, advances in antifungal treatment and educational programs in Spain. An early diagnostic and therapeutic algorithm is proposed based on the combination of scores and microbiological test. The aim of this review is to provide physicians with the best information available in order to improve the prognosis of these patients.
authors.affiliation: Unidad de Sepsis, Servicio de Medicina Intensiva, Hospital Universitario Dr. Peset, Valencia, España. Electronic address: zaragozar@ono.com.
authors.forename: Rafael
authors.initials: R
authors.lastname: Zaragoza
authors.affiliation: Servicio de Medicina Intensiva, Hospital Universitario y Politécnico La Fe, Valencia, España.
authors.forename: Paula
authors.initials: P
authors.lastname: Ramírez
authors.affiliation: Unidad de Sepsis, Servicio de Medicina Intensiva, Hospital Sont Llàtzer, Palma de Mallorca, España.
authors.forename: Marcio
authors.initials: M
authors.lastname: Borges
authors.affiliation: Servicio de Microbiología, Hospital Universitario La Fe, Valencia, España.
authors.forename: Javier
authors.initials: J
authors.lastname: Pemán
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use; D058365:Candidiasis, Invasive / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D016638:Critical Illness; D006801:Humans; D009503:Neutropenia; D017410:Practice Guidelines as Topic; D013030:Spain
chemical_list: D000935:Antifungal Agents
keywords: Candidiasis invasora; Educational project; Invasive candidiasis; Non-neutropenic critically ill patients; Paciente crítico no neutropénico; Proyecto educacional