Invasive fungal infections, especially
candidemia and
systemic candidiasis, have become a major cause of morbidity and mortality in the last few decades. This comes in parallel with the major advances made in
intensive care. Patients who are
critically ill, in medical or surgical ICUs are especially at risk for
CANDIDA infections.
Invasive candidiasis accounts for up to 15 to 30% of all
nosocomial infections in
critically ill patients. Management of these severe
infections has been challenging due to a lack of rapid and reliable diagnostic methods, leading to delays in initiating appropriate antifungal
therapy. However, some notable improvements have been made in diagnostics with improved culturing methods, rapid species identification, and detection of
fungemia with newer
antigen assays. Newer classes of antifungals have recently become available with broader antifungal activity, fewer
drug-drug interactions, and improved tolerability when compared with the older
antifungal agents. Despite these advancements, the mortality rates associated with
candidiasis remain excessively high, with an overall mortality in the range of 30 to 50% and an attributable mortality of ~30%. In addition to this high case-fatality rate,
candidemia is also associated with a substantial economic burden, primarily due to an extended
length of stay. Strategies to evaluate either the prevention, early diagnosis, or initiation of appropriate
therapy should yield both clinical and socioeconomic benefits.