Combined use of nonculture-based lab techniques in the diagnosis and management of critically ill patients with invasive fungal infections. Issue 11 (November 2012)

• Record Type: Journal Article
• Authors: Pemán, Javier; Zaragoza, Rafael
• Is Part Of: Expert review of anti-infective therapy. Volume 10:Issue 11(2012)
• Page Start: 1321
• Page End: 1330
• Publication Date: 2012-11
• Subjects: (1, 3)-β-d-glucan -- Candida albicans germ tube-specific antibodies -- fungal PCR -- galactomannan -- intensive care unit -- invasive aspergillosis -- invasive candidiasis -- invasive fungal infection -- mannan and antimannan antibodies -- nonculture-based microbiological tool; Anti-infective agents -- Research -- Periodicals; 616.90461
• DOI: 10.1586/eri.12.128
• Languages: English
• ISSNs: 1478-7210

Abstract

Invasive fungal infections are associated with high morbidity and mortality in critically ill patients due, in part, to diagnostic difficulties in the early stages. Nonculture-based techniques such as (1, 3)-β-d -glucan, galactomannan, mannan and antimannan antibodies, Candida albicans germ tube-specific antibodies or fungal DNA are required for earlier diagnosis, prognostic information and monitoring outcome. A decision-tree algorithm based on the combination of nonculture-based techniques is suggested to optimize the diagnosis and evolution of critically ill patients at risk of invasive mycoses. The use of (1, 3)-β-d -glucan and blood cultures twice a week is proposed; if positive, treatment initiation is recommended alongside the performance of the nonculture-based microbiological tool depending on suspected mycoses and the availability of techniques.