Fungal Infection Clinical Trial
Official title:
Systemic Fungal Infections in Intensive Care Unit Patients
This study aims to :
1. Diagnosis of Systemic fungal infections in ICU patients.
2. Detection the most common fungal species in ICU.
3. Detection of in vitro antifungal sensitivity pattern
Systemic fungal infections are a significant and growing public health problem ,Over the past
few years, major advances in healthcare have led to an unwelcome increase in the number of
life-threatening infections due to true pathogenic and opportunistic fungi ,These have a
significant impact on morbidity, mortality, length of hospital stay, and healthcare costs in
critically ill patients in intensive care unit ( ICU).
Health care workers encounter at risk patients in ICU in various settings : including
diabetes mellitus, renal insufficiency, surgery (especially abdominal surgery), the use of
broad-spectrum antibiotics, parenteral nutrition, hemodialysis, mechanical ventilation, the
presence of central vascular catheters, and therapy with immunosuppressive agents,Prolonged
treatment with corticosteroids before ICU admission, liver cirrhosis with prolonged ICU stay
(.7 days), solid organ cancer, HIV infection and lung transplantation are also considered as
risk factors ,It can also occur following trauma or invasion of wounds covered with
contaminated dressings, e.g. in the ICU. One outbreak of gastric mucormycosis in ICU patients
reported in Spain arose in association with the use of contaminated wooden tongue depressors
in critically ill patients.
Candida and Aspergillus species are the most frequent causes of healthcare-associated fungal
infections in these patients, Although Candida infections are the most frequent fungal
infections in ICU patients, invasive aspergillosis is associated with higher morbidity and
mortality rates even in the absence of traditional risk factors,Invasive candidiasis is a
highly lethal infection associated with mortality rates between 40 and 60 %. The five most
common Candida species are Candida albicans, Candida glabrata, Candida tropicalis, Candida
parapsilosis, and Candida krusei.
Accurate diagnosis of invasive fungal infection is crucial so that appropriate antifungal
agents can be started rapidly. However, early diagnosis is not always easy. Microscopic
examination is rapid and can be helpful but a negative result does not exclude infection.
Blood cultures are positive in only 50-70 % of cases of Candida BSI, Furthermore, it can take
several days before Candida is identified at the species level and antifungal susceptibility
data are available but remain the gold stander in diagnosis.
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