Candida and invasive mould diseases in non-neutropenic critically ill patients and patients with haematological cancer

Candida and invasive mould diseases in non-neutropenic critically ill patients and patients with haematological cancer

Author Colombo, A. L. Autor UNIFESP Google Scholar
de Almeida Junior, J. N. Google Scholar
Slavin, Monica A. Google Scholar
Chen, Sharon C-A Google Scholar
Sorrell, Tania C. Google Scholar
Abstract Critically ill patients and patients with haematological cancer are HIV-negative populations at high risk of invasive fungal infections. In intensive-care units, candidaemia and intra-abdominal candidiasis predominate, but aspergillosis has emerged as a lethal, under-recognised cause of pneumonia. In patients with haematological malignancies or who have undergone stem-cell transplantations, pulmonary disease due to aspergillus and other mould diseases predominate. In this Series paper, we provide an update on risk assessment, new diagnostic strategies, and therapeutic approaches. New concepts have emerged for use of risk prediction rules and an evidence base now exists for inclusion of biomarkers (eg, galactomannan, 1,3-beta-D-glucan, and PCR assays for Aspergillus spp) into early diagnostic and therapeutic strategies. Imaging techniques remain helpful for early diagnosis of pulmonary mould diseases, with PET techniques offering potential improvements in diagnostic specificity and evaluation of clinical response. Echinocandins and triazoles have been validated extensively for prophylaxis, empirical therapy, and targeted therapy, but an increase in intrinsically resistant fungi and emergence of secondary resistance as a result of drug-induced selection pressure are of major concern. Echinocandins remain a major component of treatment of invasive candidiasis and new triazoles are the best alternative for prophylaxis and therapy of invasive aspergillosis.
xmlui.dri2xhtml.METS-1.0.item-coverage Oxford
Language English
Sponsor National Health and Medical Research Council of Australia
National Council of Technological and Scientific Development (CNPQ)
Grant number National Health and Medical Research Council of Australia: APP1001021
National Health and Medical Research Council of Australia: APP264605
National Health and Medical Research Council of Australia: APP512307
National Health and Medical Research Council of Australia: APP331305]
CNPq: 307510/2015-8
Date 2017
Published in Lancet Infectious Diseases. Oxford, v. 17, n. 11, p. E344-E356, 2017.
ISSN 1473-3099 (Sherpa/Romeo, impact factor)
Publisher Elsevier Sci Ltd
Extent E344-E356
Origin http://dx.doi.org/10.1016/S1473-3099(17)30304-3
Access rights Closed access
Type Article
Web of Science ID WOS:000414059800002
URI https://repositorio.unifesp.br/handle/11600/58306

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