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Invasive candidiasis in critical care setting, updated recommendations from “Invasive Fungal Infections-Clinical Forum”, Iran

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World Journal of Critical Care Medicine 2014年第4期3卷 102-112页

作者： Ashraf Elhoufi Arezoo Ahmadi Amir Mohammad Hashem Asnaashari Mohammad Ali Davarpanah Behrooz Farzanegan Bidgoli Omid Moradi Moghaddam Mohammad Torabi-Nami Saeed Abbasi Malak El-Sobky Ali Ghaziani Mohammad Hossein Jarrahzadeh reza shahrami Farzad Shirazian Farhad Soltani Homeira Yazdinejad Farid Zand Department of Critical Care Medicine Dubai Hospital Dubai Health Authority Department of Anesthesiology and Critical Care Sina Hospital Tehran University of Medical Sciences Department of Pulmonology and Critical Care Ghaem Hospital Mashhad University of Medical Sciences Department of Infectious Diseases and Tropical Medicine Shiraz University of Medical Sciences Tracheal Disease Research Center Shahid Behesti University of Medical Sciences Department of Anesthesiology and Critical Care Rasoul-e-Akram Hospital Iran University of Medical Sciences Department of Neuroscience School of Advanced Medical Sciences and Technologies Shiraz University of Medical Sciences Behphar Scientific Committee Behphar Group Anesthesiology and Critical Care Research Center Isfahan University of Medical Sciences Invasive Fungal Infections-Clinical Forum Intensive Care and Burn Units Motahhari Hospital Intensive Care Unit Vali-e-Asr Hospital NAJA University Department of Anesthesiology and Critical Care Golestan Hospital Ahwaz Jundishapur University of Medical Sciences Department of Anesthesiology and Critical Care Taleghani Hospital Shahid Beheshti University of Medical Sciences Shiraz Anesthesiology and Critical Care Research Center Shiraz University of Medical Sciences

Invasive candidiasis(IC) bears a high risk of morbidity and mortality in the intensive care units(ICU). With the current advances in critical care and the use of widespectrum antibiotics, invasive fungal infections(IFIs) and IC in particular, have turned into a growing concern in the ICU. Further to blood cultures, some auxil-iary laboratory tests and biomarkers are developed to enable an earlier detection of infection, however these test are neither consistently available nor validated in our setting. On the other hand, patients' clinical status and local epidemiology data may justify the empiric antifungal approach using the proper antifungal option. The clinical approach to the management of IC in febrile, non-neutropenic critically ill patients has been defined in available international guidelines; nevertheless such recommendations need to be customized when applied to our local practice. Over the past three years, Iranian experts from intensive care and infectious diseases disciplines have tried to draw a consensus on the management of IFI with a particular focus on IC in the ICU. The established IFI-clinical forum(IFI-CF), comprising the scientific leaders in the field, has recently come up with and updated recommendation on the same(June 2014). The purpose of this review is to put together literature insights and Iranian experts' opinion at the IFI-CF, to propose an updated practical overview on recommended approaches for the management of IC in the ICU.

关键词： Invasive candidiasis Intensive care unit IFI-clinical forum Recommendations Iran

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