Title: Invasive Yeast Infections in ICU patients

Biography:

Róbert Šimon works as a general surgeon on 2nd Surgical Clinic of University Hospital in Košice, Slovakia. He is also teaching surgery at the Faculty of Medicine.

Abstract

Statement of the Problem:  Invasive yeast infections are serious systemic infections associated with high mortality. While in oncohematologic patients the most often yeast infection is invasive aspergilosis, in patients hospitalised in intensive care units it is invasive candidiasis. The main problems in intensive patients are: to define patient at risk, early diagnosis of yeast infection, and the last one - the fact, that the ratio of C. albicans and non- C. albicans candidiasis has  changed in favour of non-C. albicans strains of yeast. The greatest increase was recorded for C. parapsilosis and C. glabrata   The incidence of candidiasis significantly increases the mortality of patients, although the timely commencement of antimycotic therapy is a key factor in increasing their survival.  The presence of yeast in the blood is never considered a possible contamination of the sample, there is always a need to look for the source from which the yeast was washed into the blood. Clinical signs of invasive yeast infection are non-specific and do not differ from symptoms of bacterial infections. The relationship between hospital mortality and the delay in antimycotic therapy intervention has been demonstrated by several authors. Although, C. albicans is the most common yeast isolate presented in haemocultures, the non-C. albicans ratio has increased in recent years, especially C. glabrata and C. parapsilosis. In Luis Pasteur University hospital, among the 101 investigated samples of biological material taken from primary sterile sites between January 2013 and June 2015 form ICU patients, C. albicans were identified in most patients from ICU (48 cases, 48.6%). C. parapsilosis was identified in 8 samples (7.9%) and was the third most commonly identified non-C albicans yeast after C. glabrata and C. krusei.

Conclusion:    The most patient at risk hospitalized in ICU are: complicated surgical patients, transplant patients, patients receiving biological treatment, oncohematologic (neutropenic) patients, child whit low birth weight, immunocompromised patients, patients in malnutrition.  Therapy according ESCMID guidelines 2012 or IDSA guidelines 2016 can be helpful.