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Intensive Care Medicine
Published in: Intensive Care Medicine 4/2006

01-04-2006 | Brief Report

Candida sp. isolated from bronchoalveolar lavage: clinical significance in critically ill trauma patients

Authors: G. Christopher Wood, Eric W. Mueller, Martin A. Croce, Bradley A. Boucher, Timothy C. Fabian

Published in: Intensive Care Medicine | Issue 4/2006

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Abstract

Objective

Based on limited data, Candida sp. isolates from bronchoalveolar lavage (BAL) cultures in immunocompetent patients are thought to be contaminants rather than pathogens. The objective of this study was to determine the clinical significance of Candida sp. isolated from BAL cultures in critically ill trauma patients.

Design and setting

Retrospective study in a level 1 trauma intensive care unit.

Patients and participants

All patients with Candida sp. isolated from BAL cultures over a 3-year period; 85 Candida positive BAL cultures from 62 patients were studied.

Measurements and results

The primary outcomes were the incidence of Candida sp. in BAL, antifungal use, course of the possible infection, and mortality. Of 1077 BAL cultures 85 (8%) grew Candida sp., representing 64 episodes of possible Candida sp. ventilator-associated pneumonia. No colony counts exceeded the diagnostic threshold for bacterial VAP (≥ 105 cfu/ml). Only 2 of 64 episodes (3%) were treated with systemic antifungals. Three other episodes (5%) were treated because of concomitant therapy for Candida sp. at other sites. The majority of episodes were not treated with antifungals and were considered contaminants (59/64, 92%). No patients developed subsequent candidemia, and most follow-up BALs (74%) were negative for Candida sp. Overall mortality (17%) was similar to previous patients with similar severity of injury at the study center (18%).

Conclusions

The results of this study suggest that isolation of Candida sp. from BAL in quantities below the diagnostic threshold for VAP in this population does not require antifungal therapy.
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Metadata
Title
Candida sp. isolated from bronchoalveolar lavage: clinical significance in critically ill trauma patients
Authors
G. Christopher Wood
Eric W. Mueller
Martin A. Croce
Bradley A. Boucher
Timothy C. Fabian
Publication date
01-04-2006
Publisher
Springer-Verlag
Published in
Intensive Care Medicine / Issue 4/2006
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-005-0065-6

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