2007, Number 3
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ABSTRACTCandidemia is an entity that is prevalent in the hospital setting and is associated with high mortality. In the last decade there have been major epidemiological changes in Candida blood borne infections (especially non-albican species), strongly associated with the introduction of azoles. Critically ill patients often have multiple risk factors for developing candidemia and deep Candida infections. Diagnosis of this entity still relies mainly on clinical grounds and on high medical suspicion because laboratory assays are not very specific and cultures are not a hundred percent sensitive. Species identification is important in guiding treatment because species like C. glabrata and C. krusei are fluconazole resistant. There is a great array of antifungal medications of which some are well know for them effectiveness but also for them toxicity and adverse effects; newer medications like caspofungin have demonstrated similar antifungal activity with a better safety profile. Voriconazole and posaconazole have very promising results and could be the medications of choice in the future.
Pfaller MA, Jones RN, Messer SA, Edmond MB, et al. National surveillance of nosocomial blood stream infection due to species of Candida other than Candida albicans: frequency of occurrence and antifungal susceptibility in the SCOPE program. SCOPE Participant Group. Diagn Microbiol Infect Dis 1998;30:121-9.
Pfaller MA, Jones RN, Doern GV, Sader HS, et al. International surveillance of bloodstream infections due to Candida species: frequency of occurrence and antifungal susceptibilities of isolates collected in 1997 in the United States, Canada, and South America for the SENTRY Program. The SENTRY Participant Group. J Clin Microbiol 1998;36:1886-9.