Invasive candida infections: evolution of a fungal pathogen

Article Abstract:

Fungal infections have become a major cause of infections occurring in hospitals (nosocomial infections). In particular, infections with candida have become a major problem. The results of a recent survey, conducted by the National Nosocomial Infectious Surveillance System, estimated that out of 344,610 cases of nosocomial infections reported between 1980 and 1990, 8 percent were caused by fungi, of which 79 percent were caused by candida. Candida is a fungus that is normally present in the human gastrointestinal tract. Under conditions that upset the normal balance of microorganisms present in the gut, such as antibiotic or chemotherapeutic treatments, candida can cause severe infection and disease. Improved methods for the diagnosis of candida infections are needed because a large number of patients with undiagnosed invasive candida infections die. The results of a recent study, published in the April 11, 1991 issue of the New England Journal of Medicine, indicate that testing blood samples for the presence of a specific candida antigen (enolase, an enzyme made by candida) may improve the diagnosis of candida infections when used in combination with blood cultures. When performed only once on each blood sample, this test was able to identify 52 percent of the cases of candida infection in a group of patients who had confirmed candida infection. However, when individual blood samples were tested several times, this test identified 85 percent of the cases of candida infection. Fungal infections are more difficult to treat than bacterial infections. The treatment of choice for life-threatening candida infections is amphotericin B and flucytosine. Less severe infections of the mucus membranes and skin can be treated with ketoconazole or fluconazole. Future developments in diagnostic testing and drug therapy will improve the treatment of patients with candida infections. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnosis, Drug therapy, Candidiasis, Candida, editorial

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An intervention to decrease catheter-related bloodstream infections in the ICU

Article Abstract:

Catheter-related bloodstream infections occurring in the intensive care unit (ICU) are common, costly, and potentially lethal. A collaborative cohort study conducted in ICUs in Michigan found that evidence-based intervention resulted in a large and sustained reduction (up to 66%) in catheter-related bloodstream infections that was maintained throughout the 18-month study period.

Michigan, Analysis, Usage, Nosocomial infections, Cross infection, Catheters

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