Invasive candidiasis in critical care setting, updated recommendations from “Invasive Fungal Infections-Clinical Forum”, Iran

Abstract

Author contributions: Elhoufi A moderated the clinical forum and contributed to literature review; other than the first author, at second order, Ahmadi A, Asnaashari AMH, Davarpanah MA, Farzanegan Bidgoli B, Moradi Moghaddam O and Torabi-Nami M equally contributed to literature review and plenary talks as well as summary of recommendations (sorted alphabetically as second-order authors); at third order, Abbasi S, El-Sobky M, Ghaziani A, Jarrahzadeh MH, Shahrami R, Shirazian F, Soltani F, Yazdinejad H and Zand F equally contributed to this consensus through inputs and critical reversion of the manuscript for im-portant intellectual content (sorted alphabetically as third-order authors); Torabi-Nami M drafted the manuscript; Torabi-Nami M and El-Sobky M provided technical material support; all authors read and approved the final manuscript. Abstract Invasive candidiasis (IC) bears a high risk of morbidity and mortality in the intensive care units (ICU). With the current advances in critical care and the use of wide-spectrum antibiotics, invasive fungal infections (IFIs) and IC in particular, have turned into a growing con-cern in the ICU. Further to blood cultures, some auxil- 102 November 4, 2014|Volume 3|Issue 4| WJCCM|www.wjgnet.com iary laboratory tests and biomarkers are developed to enable an earlier detection of infection, however these test are neither consistently available nor validated in our setting. On the other hand, patients' clinical status and local epidemiology data may justify the empiric antifungal approach using the proper antifungal option. The clinical approach to the management of IC in fe-brile, non-neutropenic critically ill patients has been de-fined in available international guidelines; nevertheless such recommendations need to be customized when applied to our local practice. Over the past three years, Iranian experts from intensive care and infectious dis-eases disciplines have tried to draw a consensus on the management of IFI with a particular focus on IC in the ICU. The established IFI-clinical forum (IFI-CF), com-prising the scientific leaders in the field, has recently come up with and updated recommendation on the same (June 2014). The purpose of this review is to put together literature insights and Iranian experts' opinion at the IFI-CF, to propose an updated practical overview on recommended approaches for the management of IC in the ICU. Core tip: The present consensus statement has at-tempted to summarize the practical highlights regard-ing the management of Invasive Candidiasis (IC) in critical care setting. This easy-to-follow clinical path-way is expected to be not only of interest but also of clinical use for those who deal with the management of invasive fungal infections in hospital setting and especially the intensive care units. The focus of this paper is the concept of timely management of IC in critically ill patients. Elhoufi A, Ahmadi A, Asnaashari AMH, Davarpanah MA, Far-zanegan Bidgoli B, Moradi Moghaddam O, Torabi-Nami M, Ab-basi S, El-Sobky M, Ghaziani A, Jarrahzadeh MH, Shahrami R, Shirazian F, Soltani F, Yazdinejad H, Zand F. Invasive candidiasis in critical care setting, updated recommendations from " Inva-sive Fungal Infections-Clinical Forum " , Iran. World J Crit Care Med 2014; 3(4): 102-112 Available from: