Source: Carver PL. Invasive fungal infections. In: DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey LM. Pharmacotherapy: A Pathophysiologic Approach. 10th ed. New York, NY: McGraw-Hill; 2017. http://accesspharmacy.mhmedical.com/content.aspx?bookid=1861§ionid=146073167. Accessed March 14, 2017.
Yeasts that exist primarily as small, unicellular, thin-walled, ovoid cells that reproduce by budding.
Eight species of Candida regarded as clinically important pathogens in human disease: C. albicans, C. tropicalis, C. parapsilosis, C. krusei, C. stellatoidea, C. guilliermondii, C. lusitaniae, and C. glabrata
IDSA candidiasis guideline-defined risk factors (Table 1):1
Severity of illness.
Broad spectrum antibiotics.
Recent major surgery.
Use of CVCs.
TABLE 1.Risk Factors for Invasive Candidiasis |Favorite Table|Download (.pdf) TABLE 1. Risk Factors for Invasive Candidiasis
Corrected colonization index (CCI) ≥0.4a
Colonization index (CI) ≥0.8a
Candida spp. cultured from sites other than blood.
Number of antibiotics prior to infection (per additional antibiotics)
Use of two or more antibiotics.
Use of broad-spectrum antibiotics in previous 10 days.
Surgery on ICU admission.
Cardiopulmonary bypass time >120 min.
Central venous catheter.
Triple lumen catheter in patients who have undergone surgery.
Renal failure and dialysis
Increased serum creatinineb
New-onset hemodialysis within 3 days of admission to ICU
Acute renal failure.
Underlying disease/baseline characteristics
Apache II (per point)
Signs of severe sepsis.
Diarrhea at any time.
Mechanical ventilation ≥10 days.
Hospital-acquired bacterial infection.
Bacterial peritonitis by ICU day 11
ICU length of stay.
Transferred from other hospital.
Use of corticosteroids.
Profound neutropenia (ANC < 100/mm3 [<0.100 ×109/L])