Overview
Pittet et al identified risk factors for Candida infections of surgical patients in the intensive care unit (ICU). These can help to identify a patient who may benefit from closer monitoring and more aggressive management. The authors are from University Hospital of Geneva and Centre Hospitalier Universitaire Vaudois in Switzerland.
Patient selection: surgical patient in the ICU with risk factors for Candida infections
Risk factors for Candida infection based on logistic regression analysis:
(1) high APACHE II score (>= 22) on admission to the ICU
(2) high corrected colonization index (>= 0.40) with a Candida species
A high level of colonization is reached about 1 week prior to onset of infection.
Additional risk factors:
(1) prolonged antibiotic therapy (>= 3 weeks)
(2) antibiotic therapy with more than 3 or more antibiotics during hospital stay
A high risk patient with risk factors for Candida infection may benefit from:
(1) removal or close observation of central lines, urinary catheters or other sites
(2) prophylactic or early antifungal therapy
