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Intensive Care Medicine

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Open Access 01-10-2014 | My Paper 20 Years Later

Candida colonization index and subsequent infection in critically ill surgical patients: 20 years later

Authors: Philippe Eggimann, Didier Pittet

Published in: Intensive Care Medicine | Issue 10/2014

Abstract

Introduction

For decades, clinicians dealing with immunocompromised and critically ill patients have perceived a link between Candida colonization and subsequent infection. However, the pathophysiological progression from colonization to infection was clearly established only through the formal description of the colonization index (CI) in critically ill patients. Unfortunately, the literature reflects intense confusion about the pathophysiology of invasive candidiasis and specific associated risk factors.

Methods

We review the contribution of the CI in the field of Candida infection and its development in the 20 years following its original description in 1994. The development of the CI enabled an improved understanding of the pathogenesis of invasive candidiasis and the use of targeted empirical antifungal therapy in subgroups of patients at increased risk for infection.

Results

The recognition of specific characteristics among underlying conditions, such as neutropenia, solid organ transplantation, and surgical and nonsurgical critical illness, has enabled the description of distinct epidemiological patterns in the development of invasive candidiasis.

Conclusions

Despite its limited bedside practicality and before confirmation of potentially more accurate predictors, such as specific biomarkers, the CI remains an important way to characterize the dynamics of colonization, which increases early in patients who develop invasive candidiasis.

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Title: Candida colonization index and subsequent infection in critically ill surgical patients: 20 years later
Authors: Philippe Eggimann
Didier Pittet
Publication date: 01-10-2014
Publisher: Springer Berlin Heidelberg
Published in: Intensive Care Medicine / Issue 10/2014
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-014-3355-z

At a glance: The STEP trials

Springer Medicine

Candida colonization index and subsequent infection in critically ill surgical patients: 20 years later

Abstract

Introduction

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusions

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