nach oben

Erschienen in:

01.01.2010 | Intensivmedizin

Update: invasive Pilzinfektionen

Diagnose und Therapie in der operativen Intensivmedizin

verfasst von: Dr. C. Lichtenstern, S. Swoboda, M. Hirschburger, E. Domann, T. Hoppe-Tichy, M. Winkler, C. Lass-Flörl, M.A. Weigand

Erschienen in: Die Anaesthesiologie | Ausgabe 1/2010

Einloggen, um Zugang zu erhalten

Zusammenfassung

Pilzinfektionen sind in der operativen Intensivmedizin nicht selten. Candida-Spezies bilden dabei den Großteil der pilzlichen Erreger. Insbesondere bei Patienten mit vorbestehenden Lungenerkrankungen ist auch auf die Entstehung einer pulmonalen Aspergillose zu achten. Der frühzeitige Beginn der adäquaten antimykotischen Therapie ist entscheidend für den Erfolg. Hierzu ist eine Risikoabschätzung notwendig, die anhand von individuellen Patientenmerkmalen den Zeitpunkt des Behandlungsbeginns festlegt. Im Fall einer Candida-Infektion des klinisch stabilen Intensivpatienten ohne Organdysfunktion, der im Vorfeld kein Azol erhielt, bleibt Fluconazol das Mittel der Wahl, sofern die lokalen epidemiologischen Bedingungen nicht dagegen sprechen. Für instabile Intensivpatienten mit Organdysfunktionen stellen die Echinocandine aufgrund ihres breiten Wirkspektrums und ihrer guten Verträglichkeit die erste Wahl dar. Empfindlichkeitstestungen werden aufgrund des relevanten Anteils azolresistenter Candida-Spezies empfohlen. Abhängig vom nachgewiesenen Erreger ist das Umsetzen der Therapie auf ein Azol nach klinischer Stabilisierung möglich. Eine Aspergillose wird primär mit Voriconazol behandelt.

Abele-Horn M, Kopp A, Sternberg U et al (1996) A randomized study comparing fluconazole with amphotericin B/5-flucytosine for the treatment of systemic Candida infections in intensive care patients. Infection 24:426–432PubMed

Abi-Said D, Anaissie E, Uzun O et al (1997) The epidemiology of hematogenous candidiasis caused by different Candida species. Clin Infect Dis 24:1122–1128PubMed

Alexander B, Pfaller MA (2006) Contemporary tools for the diagnosis and management of invasive mycoses. Clin Infect Dis 43:S15–S23

Alexander BD, Ashley ED, Reller LB et al (2006) Cost savings with implementation of PNA FISH testing for identification of Candida albicans in blood cultures. Diagn Microbiol Infect Dis 54:277–282PubMed

Almirante B, Rodriguez D, Park BJ et al (2005) Epidemiology and predictors of mortality in cases of Candida bloodstream infection: results from population-based surveillance, Barcelona, Spain, from 2002 to 2003. J Clin Microbiol 43:1829–1835PubMed

Alvarez-Lerma F, Nolla-Salas J, Leon C et al (2003) Candiduria in critically ill patients admitted to intensive care medical units. Intensive Care Med 29:1069–1076PubMed

Anaissie EJ, Darouiche RO, Abi-Said D et al (1996) Management of invasive candidal infections: results of a prospective, randomized, multicenter study of fluconazole versus amphotericin B and review of the literature. Clin Infect Dis 23:964–972PubMed

Anaissie EJ, Vartivarian SE, Abi-Said D et al (1996) Fluconazole versus amphotericin B in the treatment of hematogenous candidiasis: a matched cohort study. Am J Med 101:170–176PubMed

Anonymous (2005) Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia. Am J Respir Crit Care Med 171:388–416

10.

Antoniadou A, Torres HA, Lewis RE et al (2003) Candidemia in a tertiary care cancer center: in vitro susceptibility and its association with outcome of initial antifungal therapy. Medicine (Baltimore) 82:309–321

11.

Arendrup MC, Fuursted K, Gahrn-Hansen B et al (2005) Seminational surveillance of fungemia in Denmark: notably high rates of fungemia and numbers of isolates with reduced azole susceptibility. J Clin Microbiol 43:4434–4440PubMed

12.

Asmundsdottir LR, Erlendsdottir H, Gottfredsson M (2002) Increasing incidence of candidemia: results from a 20-year nationwide study in Iceland. J Clin Microbiol 40:3489–3492PubMed

13.

Azoulay E, Cohen Y, Zahar JR et al (2004) Practices in non-neutropenic ICU patients with Candida-positive airway specimens. Intensive Care Med 30:1384–1389PubMed

14.

Bates DW, Su L, Yu DT et al (2001) Mortality and costs of acute renal failure associated with amphotericin B therapy. Clin Infect Dis 32:686–693PubMed

15.

Ben-Ami R, Weinberger M, Orni-Wasserlauff R et al (2008) Time to blood culture positivity as a marker for catheter-related candidemia. J Clin Microbiol 46:2222–2226PubMed

16.

Blot S, Vandewoude K, Hoste E et al (2001) Outcome in critically ill patients with candidal fungaemia: Candida albicans vs. Candida glabrata. J Hosp Infect 47:308–313PubMed

17.

Blot SI, Vandewoude KH, De Waele JJ (2007) Candida peritonitis. Curr Opin Crit Care 13:195–199PubMed

18.

Blot SI, Vandewoude KH, Hoste EA et al (2002) Effects of nosocomial candidemia on outcomes of critically ill patients. Am J Med 113:480–485PubMed

19.

Borg-Von Zepelin M, Kunz L, Ruchel R et al (2007) Epidemiology and antifungal susceptibilities of Candida spp. to six antifungal agents: results from a surveillance study on fungaemia in Germany from July 2004 to August 2005. J Antimicrob Chemother 60:424–428

20.

Bougnoux ME, Kac G, Aegerter P et al (2008) Candidemia and candiduria in critically ill patients admitted to intensive care units in France: incidence, molecular diversity, management and outcome. Intensive Care Med 34:292–299PubMed

21.

Boutati EI, Anaissie EJ (1997) Fusarium, a significant emerging pathogen in patients with hematologic malignancy: ten years‘ experience at a cancer center and implications for management. Blood 90:999–1008PubMed

22.

Bowden R, Chandrasekar P, White MH et al (2002) A double-blind, randomized, controlled trial of amphotericin B colloidal dispersion versus amphotericin B for treatment of invasive aspergillosis in immunocompromised patients. Clin Infect Dis 35:359–366PubMed

23.

Boyd AE, Modi S, Howard SJ et al (2004) Adverse reactions to voriconazole. Clin Infect Dis 39:1241–1244PubMed

24.

Caillot D, Couaillier JF, Bernard A et al (2001) Increasing volume and changing characteristics of invasive pulmonary aspergillosis on sequential thoracic computed tomography scans in patients with neutropenia. J Clin Oncol 19:253–259PubMed

25.

Caillot D, Thiebaut A, Herbrecht R et al (2007) Liposomal amphotericin B in combination with caspofungin for invasive aspergillosis in patients with hematologic malignancies: a randomized pilot study (Combistrat trial). Cancer 110:2740–2746PubMed

26.

Casado JL, Quereda C, Corral I (1998) Candidal meningitis in HIV-infected patients. AIDS Patient Care STDS 12:681–686PubMed

27.

Chaturvedi V, Ramani R, Andes D et al (2008) Multilaboratory testing of antifungal combinations (M-1538). In: ICAAC. Washington

28.

Chow JK, Golan Y, Ruthazer R et al (2008) Risk factors for albicans and non-albicans candidemia in the intensive care unit. Crit Care Med 36:1993–1998PubMed

29.

Clancy CJ, Jaber RA, Leather HL et al (2007) Bronchoalveolar lavage galactomannan in diagnosis of invasive pulmonary aspergillosis among solid-organ transplant recipients. J Clin Microbiol 45:1759–1765PubMed

30.

Clark TA, Slavinski SA, Morgan J et al (2004) Epidemiologic and molecular characterization of an outbreak of Candida parapsilosis bloodstream infections in a community hospital. J Clin Microbiol 42:4468–4472PubMed

31.

Collins CD, Eschenauer GA, Salo SL et al (2007) To test or not to test: a cost minimization analysis of susceptibility testing for patients with documented Candida glabrata fungemias. J Clin Microbiol 45:1884–1888PubMed

32.

Cornely OA, Lasso M, Betts R et al (2007) Caspofungin for the treatment of less common forms of invasive candidiasis. J Antimicrob Chemother 60:363–369PubMed

33.

Cornely OA, Maertens J, Bresnik M et al (2007) Liposomal amphotericin B as initial therapy for invasive mold infection: a randomized trial comparing a high-loading dose regimen with standard dosing (AmBiLoad trial). Clin Infect Dis 44:1289–1297PubMed

34.

Cornely OA, Maertens J, Winston DJ et al (2007) Posaconazole vs. fluconazole or itraconazole prophylaxis in patients with neutropenia. N Engl J Med 356:348–359PubMed

35.

Cornely OA, Ostrosky-Zeichner L, Morris MI et al (2008) Non-drug factors related to survival and treatment success in patients with invasive candidiasis or candidemia: a meta-analysis of two large, prospective, micafungin trials (K-1393) In: ICAAC. Washington

36.

Cornillet A, Camus C, Nimubona S et al (2006) Comparison of epidemiological, clinical, and biological features of invasive aspergillosis in neutropenic and nonneutropenic patients: a 6-year survey. Clin Infect Dis 43:577–584PubMed

37.

De Pauw B, Walsh TJ, Donnelly JP et al (2008) Revised definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) Consensus Group. Clin Infect Dis 46:1813–1821

38.

De Smet AM, Kluytmans JA, Cooper BS et al (2009) Decontamination of the digestive tract and oropharynx in ICU patients. N Engl J Med 360:20–31

39.

Denning DW, Lee JY, Hostetler JS et al (1994) NIAID mycoses study group multicenter trial of oral itraconazole therapy for invasive aspergillosis. Am J Med 97:135–144PubMed

40.

Diekema DJ, Messer SA, Hollis RJ et al (2003) Activities of caspofungin, itraconazole, posaconazole, ravuconazole, voriconazole, and amphotericin B against 448 recent clinical isolates of filamentous fungi. J Clin Microbiol 41:3623–3626PubMed

41.

Dimopoulos G, Ntziora F, Rachiotis G et al (2008) Candida albicans versus non-albicans intensive care unit-acquired bloodstream infections: differences in risk factors and outcome. Anesth Analg 106:523–529, table of contentsPubMed

42.

Dinubile MJ, Lupinacci RJ, Strohmaier KM et al (2007) Invasive candidiasis treated in the intensive care unit: observations from a randomized clinical trial. J Crit Care 22:237–244PubMed

43.

Dupont H, Paugam-Burtz C, Muller-Serieys C et al (2002) Predictive factors of mortality due to polymicrobial peritonitis with Candida isolation in peritoneal fluid in critically ill patients. Arch Surg 137:1341–1346PubMed

44.

Eggimann P, Garbino J, Pittet D (2003) Epidemiology of Candida species infections in critically ill non-immunosuppressed patients. Lancet Infect Dis 3:685–702PubMed

45.

Einsele H, Loeffler J (2008) Contribution of new diagnostic approaches to antifungal treatment plans in high-risk haematology patients. Clin Microbiol Infect 14 (Suppl 4):37–45PubMed

46.

Engel C, Brunkhorst FM, Bone HG et al (2007) Epidemiology of sepsis in Germany: results from a national prospective multicenter study. Intensive Care Med 33:606–618PubMed

47.

Forrest GN, Mankes K, Jabra-Rizk MA et al (2006) Peptide nucleic acid fluorescence in situ hybridization-based identification of Candida albicans and its impact on mortality and antifungal therapy costs. J Clin Microbiol 44:3381–3383PubMed

48.

Garey KW, Rege M, Pai MP et al (2006) Time to initiation of fluconazole therapy impacts mortality in patients with candidemia: a multi-institutional study. Clin Infect Dis 43:25–31PubMed

49.

Garnacho-Montero J, Amaya-Villar R, Ortiz-Leyba C et al (2005) Isolation of Aspergillus spp. from the respiratory tract in critically ill patients: risk factors, clinical presentation and outcome. Crit Care 9:R191–R199PubMed

50.

Greene RE, Schlamm HT, Oestmann JW et al (2007) Imaging findings in acute invasive pulmonary aspergillosis: clinical significance of the halo sign. Clin Infect Dis 44:373–379PubMed

51.

Groetzner J, Kaczmarek I, Wittwer T et al (2008) Caspofungin as first-line therapy for the treatment of invasive aspergillosis after thoracic organ transplantation. J Heart Lung Transplant 27:1–6PubMed

52.

Guarro J, Kantarcioglu AS, Horre R et al (2006) Scedosporium apiospermum: changing clinical spectrum of a therapy-refractory opportunist. Med Mycol 44:295–327PubMed

53.

Guery BP, Arendrup MC, Auzinger G et al (2009) Management of invasive candidiasis and candidemia in adult non-neutropenic intensive care unit patients: Part II. Treatment. Intensive Care Med 35:206–214PubMed

54.

Guinea J, Jensen J, Torres-Narbona M et al (2008) Chronic obstructive pulmonary disease (COPD) is currently the most common predisposing condition to invasive aspergillosis (M-717). In: ICAAC. Washington

55.

Hachem RY, Boktour MR, Hanna HA et al (2008) Amphotericin B lipid complex versus liposomal amphotericin B monotherapy for invasive aspergillosis in patients with hematologic malignancy. Cancer 112:1282–1287PubMed

56.

Hachem RY, Kontoyiannis DP, Boktour MR et al (2004) Aspergillus terreus: an emerging amphotericin B-resistant opportunistic mold in patients with hematologic malignancies. Cancer 101:1594–1600PubMed

57.

Hachem RY, Kontoyiannis DP, Chemaly RF et al (2009) The utility of galactomannan enzyme immunoassay and (1–3) {beta}-D-glucan in the diagnosis of invasive fungal infections: low sensitivity for Aspergillus fumigatus infection in hematologic malignancy patients. J Clin Microbiol 47:129-133PubMed

58.

Harbarth S, Burke JP, Lloyd JF et al (2002) Clinical and economic outcomes of conventional amphotericin B-associated nephrotoxicity. Clin Infect Dis 35:e120–e127PubMed

59.

Harris AD, Castro J, Sheppard DC et al (1999) Risk factors for nosocomial candiduria due to Candida glabrata and Candida albicans. Clin Infect Dis 29:926–928PubMed

60.

Herbrecht R, Denning DW, Patterson TF et al (2002) Voriconazole versus amphotericin B for primary therapy of invasive aspergillosis. N Engl J Med 347:408–415PubMed

61.

Husain S, Clancy CJ, Nguyen MH et al (2008) Performance characteristics of the platelia Aspergillus enzyme immunoassay for detection of Aspergillus galactomannan antigen in bronchoalveolar lavage fluid. Clin Vaccine Immunol 15:1760-1763PubMed

62.

Iwen PC, Hinrichs SH, Rupp ME (2002) Utilization of the internal transcribed spacer regions as molecular targets to detect and identify human fungal pathogens. Med Mycol 40:87–109PubMed

63.

Jojima H (2001) Early diagnosis and treatment of pulmonary opportunistic infection by using polymerase chain reaction and beta-glucan in patients with hematological neoplasms. Kurume Med J 48:117–127PubMed

64.

Kakkar F, Gharabaghi F, Richardson SE (2008) Utility of a pan-fungal PCR for identification of fungi from fresh and fixed tissue (M-710a). In: ICAAC. Washington

65.

Kato A, Takita T, Furuhashi M et al (2001) Elevation of blood (1−>3)-beta-D-glucan concentrations in hemodialysis patients. Nephron 89:15–19PubMed

66.

Kauffman CA, Vazquez JA, Sobel JD et al (2000) Prospective multicenter surveillance study of funguria in hospitalized patients. The National Institute for Allergy and Infectious Diseases (NIAID) Mycoses Study Group. Clin Infect Dis 30:14–18PubMed

67.

Kawazu M, Kanda Y, Nannya Y et al (2004) Prospective comparison of the diagnostic potential of real-time PCR, double-sandwich enzyme-linked immunosorbent assay for galactomannan, and a (1−>3)-beta-D-glucan test in weekly screening for invasive aspergillosis in patients with hematological disorders. J Clin Microbiol 42:2733–2741PubMed

68.

Khawcharoenporn T, Apisarnthanarak A, Mundy LM (2007) Non-neoformans cryptococcal infections: a systematic review. Infection 35:51–58PubMed

69.

Khawcharoenporn T, Apisarnthanarak A, Mundy LM (2007) Treatment of cryptococcosis in the setting of HIV coinfection. Expert Rev Anti Infect Ther 5:1019–1030PubMed

70.

Kontoyiannis DP, Boktour M, Hanna H et al (2005) Itraconazole added to a lipid formulation of amphotericin B does not improve outcome of primary treatment of invasive aspergillosis. Cancer 103:2334–2337PubMed

71.

Kontoyiannis DP, Hachem R, Lewis RE et al (2003) Efficacy and toxicity of caspofungin in combination with liposomal amphotericin B as primary or salvage treatment of invasive aspergillosis in patients with hematologic malignancies. Cancer 98:292–299PubMed

72.

Kontoyiannis DP, Ratanatharathorn V, Young JA et al (2009) Micafungin alone or in combination with other systemic antifungal therapies in hematopoietic stem cell transplant recipients with invasive aspergillosis. Transpl Infect Dis 11:89-93PubMed

73.

Kuhn DM, Chandra J, Mukherjee PK et al (2002) Comparison of biofilms formed by Candida albicans and Candida parapsilosis on bioprosthetic surfaces. Infect Immun 70:878–888PubMed

74.

Kuhn DM, Mikherjee PK, Clark TA et al (2004) Candida parapsilosis characterization in an outbreak setting. Emerg Infect Dis 10:1074–1081PubMed

75.

Kullberg BJ, Sobel JD, Ruhnke M et al (2005) Voriconazole versus a regimen of amphotericin B followed by fluconazole for candidaemia in non-neutropenic patients: a randomised non-inferiority trial. Lancet 366:1435–1442PubMed

76.

Kumar A, Group CS (2007) The high mortality of Candida septic shock is explained by excessive delays in initiation of antifungal therapy. ICAAC (Chicago) Abstract K-2174

77.

Kunova A, Trupl J, Dluholucky S et al (1995) Use of fluconazole is not associated with a higher incidence of Candida krusei and other non-albicans Candida species. Clin Infect Dis 21:226–227PubMed

78.

Kuse ER, Chetchotisakd P, Da Cunha CA et al (2007) Micafungin versus liposomal amphotericin B for candidaemia and invasive candidosis: a phase III randomised double-blind trial. Lancet 369:1519–1527PubMed

79.

Kwak EJ, Husain S, Obman A et al (2004) Efficacy of galactomannan antigen in the Platelia Aspergillus enzyme immunoassay for diagnosis of invasive aspergillosis in liver transplant recipients. J Clin Microbiol 42:435–438PubMed

80.

Leenders AC, Daenen S, Jansen RL et al (1998) Liposomal amphotericin B compared with amphotericin B deoxycholate in the treatment of documented and suspected neutropenia-associated invasive fungal infections. Br J Haematol 103:205–212PubMed

81.

Leon C, Ruiz-Santana S, Saavedra P et al (2006) A bedside scoring system („Candida score“) for early antifungal treatment in nonneutropenic critically ill patients with Candida colonization. Crit Care Med 34:730–737PubMed

82.

Leon C, Ruiz-Santana S, Saavedra P et al (2009) Usefulness of the „Candida score“ for discriminating between Candida colonization and invasive candidiasis in non-neutropenic critically ill patients: a prospective multicenter study. Crit Care Med 37:1624–1633PubMed

83.

Lin MY, Carmeli Y, Zumsteg J et al (2005) Prior antimicrobial therapy and risk for hospital-acquired Candida glabrata and Candida krusei fungemia: a case-case-control study. Antimicrob Agents Chemother 49:4555–4560PubMed

84.

Lodes U, Meyer F, Bohmeier B et al (2008) Sepsisdiagnostik chirurgischer Intensivpatienten mit dem „Lightcycler“ Septifast®-Test (Poster 286). In: 125. Kongress der Deutschen Gesellschaft für Chirurgie. Deutsche Gesellschaft für Chirurgie, Berlin

85.

Lundstrom T, Sobel J (2001) Nosocomial candiduria: a review. Clin Infect Dis 32:1602–1607PubMed

86.

Luzzati R, Amalfitano G, Lazzarini L et al (2000) Nosocomial candidemia in non-neutropenic patients at an Italian tertiary care hospital. Eur J Clin Microbiol Infect Dis 19:602–607PubMed

87.

Maertens J, Glasmacher A, Herbrecht R et al (2006) Multicenter, noncomparative study of caspofungin in combination with other antifungals as salvage therapy in adults with invasive aspergillosis. Cancer 107:2888–2897PubMed

88.

Maertens J, Raad I, Petrikkos G et al (2004) Efficacy and safety of caspofungin for treatment of invasive aspergillosis in patients refractory to or intolerant of conventional antifungal therapy. Clin Infect Dis 39:1563–1571PubMed

89.

Maertens J, Theunissen K, Verhoef G et al (2005) Galactomannan and computed tomography-based preemptive antifungal therapy in neutropenic patients at high risk for invasive fungal infection: a prospective feasibility study. Clin Infect Dis 41:1242–1250PubMed

90.

Maertens J, Verhaegen J, Demuynck H et al (1999) Autopsy-controlled prospective evaluation of serial screening for circulating galactomannan by a sandwich enzyme-linked immunosorbent assay for hematological patients at risk for invasive Aspergillosis. J Clin Microbiol 37:3223–3228PubMed

91.

Malani AN, Kauffman CA (2007) Changing epidemiology of rare mould infections: implications for therapy. Drugs 67:1803–1812PubMed

92.

Marr KA, Balajee SA, Mclaughlin L et al (2004) Detection of galactomannan antigenemia by enzyme immunoassay for the diagnosis of invasive aspergillosis: variables that affect performance. J Infect Dis 190:641–649PubMed

93.

Marr KA, Boeckh M, Carter RA et al (2004) Combination antifungal therapy for invasive aspergillosis. Clin Infect Dis 39:797–802PubMed

94.

Marr KA, Carter RA, Crippa F et al (2002) Epidemiology and outcome of mould infections in hematopoietic stem cell transplant recipients. Clin Infect Dis 34:909–917PubMed

95.

Martin GS, Mannino DM, Eaton S et al (2003) The epidemiology of sepsis in the United States from 1979 through 2000. N Engl J Med 348:1546–1554PubMed

96.

Maschmeyer G, Beinert T, Buchheidt D et al (2003) Diagnosis and antimicrobial therapy of pulmonary infiltrates in febrile neutropenic patients–guidelines of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Oncology (DGHO). Ann Hematol 82 (Suppl 2):S118–S126PubMed

97.

Mattei D, Rapezzi D, Mordini N et al (2004) False-positive Aspergillus galactomannan enzyme-linked immunosorbent assay results in vivo during amoxicillin-clavulanic acid treatment. J Clin Microbiol 42:5362–5363PubMed

98.

Meersseman W, Lagrou K, Maertens J et al (2007) Invasive aspergillosis in the intensive care unit. Clin Infect Dis 45:205–216PubMed

99.

Meersseman W, Lagrou K, Maertens J et al (2008) Galactomannan in bronchoalveolar lavage fluid: a tool for diagnosing aspergillosis in intensive care unit patients. Am J Respir Crit Care Med 177:27–34PubMed

100.

Meersseman W, Lagrou K, Spriet I et al (2009) Significance of the isolation of Candida species from airway samples in critically ill patients: a prospective, autopsy study. Intensive Care Med 35:1526-1531PubMed

101.

Meersseman W, Van Wijngaerden E (2007) Invasive aspergillosis in the ICU: an emerging disease. Intensive Care Med 33:1679–1681PubMed

102.

Mennink-Kersten MA, Donnelly JP, Verweij PE (2004) Detection of circulating galactomannan for the diagnosis and management of invasive aspergillosis. Lancet Infect Dis 4:349–357PubMed

103.

Miyazaki T, Kohno S, Mitsutake K et al (1995) Plasma (1−>3)-beta-D-glucan and fungal antigenemia in patients with candidemia, aspergillosis, and cryptococcosis. J Clin Microbiol 33:3115–3118PubMed

104.

Montravers P, Dupont H, Gauzit R et al (2006) Candida as a risk factor for mortality in peritonitis. Crit Care Med 34:646–652PubMed

105.

Mora-Duarte J, Betts R, Rotstein C et al (2002) Comparison of caspofungin and amphotericin B for invasive candidiasis. N Engl J Med 347:2020–2029PubMed

106.

Morgan J, Meltzer MI, Plikaytis BD et al (2005) Excess mortality, hospital stay, and cost due to candidemia: a case-control study using data from population-based candidemia surveillance. Infect Control Hosp Epidemiol 26:540–547PubMed

107.

Morrell M, Fraser VJ, Kollef MH (2005) Delaying the empiric treatment of candida bloodstream infection until positive blood culture results are obtained: a potential risk factor for hospital mortality. Antimicrob Agents Chemother 49:3640–3645PubMed

108.

Musher B, Fredricks D, Leisenring W et al (2004) Aspergillus galactomannan enzyme immunoassay and quantitative PCR for diagnosis of invasive aspergillosis with bronchoalveolar lavage fluid. J Clin Microbiol 42:5517–5522PubMed

109.

Nakao A, Yasui M, Kawagoe T et al (1997) False-positive endotoxemia derives from gauze glucan after hepatectomy for hepatocellular carcinoma with cirrhosis. Hepatogastroenterology 44:1413–1418PubMed

110.

Nguyen MH, Peacock JE Jr, Tanner DC et al (1995) Therapeutic approaches in patients with candidemia. Evaluation in a multicenter, prospective, observational study. Arch Intern Med 155:2429–2435PubMed

111.

Nucci M, Anaissie EJ, Queiroz-Telles F et al (2003) Outcome predictors of 84 patients with hematologic malignancies and Fusarium infection. Cancer 98:315–319PubMed

112.

Nucci M, Marr KA (2005) Emerging fungal diseases. Clin Infect Dis 41:521–526PubMed

113.

Odds FC, Hanson MF, Davidson AD et al (2007) One year prospective survey of Candida bloodstream infections in Scotland. J Med Microbiol 56:1066–1075PubMed

114.

Ostrosky-Zeichner L, Alexander BD, Kett DH et al (2005) Multicenter clinical evaluation of the (1−>3) beta-D-glucan assay as an aid to diagnosis of fungal infections in humans. Clin Infect Dis 41:654–659PubMed

115.

Ostrosky-Zeichner L, Aranha L, Eggiman P et al (2008) Preliminary results of a multicenter, international, retrospective study to validate a clinical prediction rule (CPR) to identify critically ill patients at risk of invasive candidiasis (IC) for treatment with empirical antifungal therapy (TREAT Study) (M-1853). In: ICAAC. Washington

116.

Ostrosky-Zeichner L, Marr KA, Rex JH et al (2003) Amphotericin B: time for a new „gold standard“. Clin Infect Dis 37:415–425PubMed

117.

Ostrosky-Zeichner L, Pappas P (2006) Invasive candidiasis in the intensive care unit. Crit Care Med 34:857–863PubMed

118.

Ostrosky-Zeichner L, Sable C, Sobel J et al (2007) Multicenter retrospective development and validation of a clinical prediction rule for nosocomial invasive candidiasis in the intensive care setting. Eur J Clin Microbiol Infect Dis 26:271–276PubMed

119.

Pachl J, Svoboda P, Jacobs F et al (2006) A randomized, blinded, multicenter trial of lipid-associated amphotericin B alone versus in combination with an antibody-based inhibitor of heat shock protein 90 in patients with invasive candidiasis. Clin Infect Dis 42:1404–1413PubMed

120.

Pappas PG, Kauffman CA, Andes D et al (2009) Clinical practice guidelines for the management of candidiasis: 2009 update by the Infectious Diseases Society of America. Clin Infect Dis 48:503–535PubMed

121.

Pappas PG, Rex JH, Lee J et al (2003) A prospective observational study of candidemia: epidemiology, therapy, and influences on mortality in hospitalized adult and pediatric patients. Clin Infect Dis 37:634–643PubMed

122.

Pappas PG, Rex JH, Sobel JD et al (2004) Guidelines for treatment of candidiasis. Clin Infect Dis 38:161–189PubMed

123.

Pappas PG, Rotstein CM, Betts RF et al (2007) Micafungin versus caspofungin for treatment of candidemia and other forms of invasive candidiasis. Clin Infect Dis 45:883–893PubMed

124.

Parkins MD, Sabuda DM, Elsayed S et al (2007) Adequacy of empirical antifungal therapy and effect on outcome among patients with invasive Candida species infections. J Antimicrob Chemother 60:613–618PubMed

125.

Pascual A, Calandra T, Bolay S et al (2008) Voriconazole therapeutic drug monitoring in patients with invasive mycoses improves efficacy and safety outcomes. Clin Infect Dis 46:201–211PubMed

126.

Perfect JR (2005) Treatment of non-Aspergillus moulds in immunocompromised patients, with amphotericin B lipid complex. Clin Infect Dis 40 (Suppl 6):S401–S408PubMed

127.

Perfect JR, Cox GM, Lee JY et al (2001) The impact of culture isolation of Aspergillus species: a hospital-based survey of aspergillosis. Clin Infect Dis 33:1824–1833PubMed

128.

Perfect JR, Marr KA, Walsh TJ et al (2003) Voriconazole treatment for less-common, emerging, or refractory fungal infections. Clin Infect Dis 36:1122–1131PubMed

129.

Perlroth J, Choi B, Spellberg B (2007) Nosocomial fungal infections: epidemiology, diagnosis, and treatment. Med Mycol 45:321–346PubMed

130.

Pfaller M, Pappas P, Wingard J (2006) Invasive fungal pathogens: current epidemiological trends. Clin Infect Dis 43:S3–S14

131.

Pfaller MA, Diekema DJ (2007) Epidemiology of invasive candidiasis: a persistent public health problem. Clin Microbiol Rev 20:133–163PubMed

132.

Pfaller MA, Diekema DJ (2004) Rare and emerging opportunistic fungal pathogens: concern for resistance beyond Candida albicans and Aspergillus fumigatus. J Clin Microbiol 42:4419–4431PubMed

133.

Pfaller MA, Diekema DJ, Gibbs DL et al (2008) Geographic and temporal trends in isolation and antifungal susceptibility of Candida parapsilosis: a global assessment from the ARTEMIS DISK Antifungal Surveillance Program, 2001 to 2005. J Clin Microbiol 46:842–849PubMed

134.

Phillips P, Shafran S, Garber G et al (1997) Multicenter randomized trial of fluconazole versus amphotericin B for treatment of candidemia in non-neutropenic patients. Canadian Candidemia Study Group. Eur J Clin Microbiol Infect Dis 16:337–345PubMed

135.

Piarroux R, Grenouillet F, Balvay P et al (2004) Assessment of preemptive treatment to prevent severe candidiasis in critically ill surgical patients. Crit Care Med 32:2443–2449PubMed

136.

Pittet D, Monod M, Suter PM et al (1994) Candida colonization and subsequent infections in critically ill surgical patients. Ann Surg 220:751–758PubMed

137.

Playford EG, Marriott D, Nguyen Q et al (2008) Candidemia in nonneutropenic critically ill patients: risk factors for non-albicans Candida spp. Crit Care Med 36:2034–2039PubMed

138.

Popp AI, White MH, Quadri T et al (1999) Amphotericin B with and without itraconazole for invasive aspergillosis: A three-year retrospective study. Int J Infect Dis 3:157–160PubMed

139.

Qazzafi Z, Thiruchunapalli D, Birkenhead D et al (2007) Invasive Cryptococcus neoformans infection in an asplenic patient. J Infect 55:566–568PubMed

140.

Raad II, Hachem RY, Herbrecht R et al (2006) Posaconazole as salvage treatment for invasive fusariosis in patients with underlying hematologic malignancy and other conditions. Clin Infect Dis 42:1398–1403PubMed

141.

Reboli AC, Rotstein C, Pappas PG et al (2007) Anidulafungin versus fluconazole for invasive candidiasis. N Engl J Med 356:2472–2482PubMed

142.

Rello J, Paiva JA, Baraibar J et al (2001) International conference for the development of consensus on the diagnosis and treatment of ventilator-associated pneumonia. Chest 120:955–970PubMed

143.

Rex JH, Bennett JE, Sugar AM et al (1995) Intravascular catheter exchange and duration of candidemia. NIAID Mycoses Study Group and the Candidemia Study Group. Clin Infect Dis 21:994–996PubMed

144.

Rex JH, Bennett JE, Sugar AM et al (1994) A randomized trial comparing fluconazole with amphotericin B for the treatment of candidemia in patients without neutropenia. Candidemia Study Group and the National Institute. N Engl J Med 331:1325–1330PubMed

145.

Rex JH, Pappas PG, Karchmer AW et al (2003) A randomized and blinded multicenter trial of high-dose fluconazole plus placebo versus fluconazole plus amphotericin B as therapy for candidemia and its consequences in nonneutropenic subjects. Clin Infect Dis 36:1221–1228PubMed

146.

Richards MJ, Edwards JR, Culver DH et al (2000) Nosocomial infections in combined medical-surgical intensive care units in the United States. Infect Control Hosp Epidemiol 21:510–515PubMed

147.

Richardson M, Lass-Florl C (2008) Changing epidemiology of systemic fungal infections. Clin Microbiol Infect 14 (Suppl 4):5–24PubMed

148.

Rijnders BJ, Cornelissen JJ, Slobbe L et al (2008) Aerosolized liposomal amphotericin B for the prevention of invasive pulmonary aspergillosis during prolonged neutropenia: a randomized, placebo-controlled trial. Clin Infect Dis 46:1401–1408PubMed

149.

Sandven P, Qvist H, Skovlund E et al (2002) Significance of Candida recovered from intraoperative specimens in patients with intra-abdominal perforations. Crit Care Med 30:541–547PubMed

150.

Schinabeck MK, Ghannoum MA (2003) Human hyalohyphomycoses: a review of human infections due to Acremonium spp., Paecilomyces spp., Penicillium spp., and Scopulariopsis spp. J Chemother 15(Suppl 2):5–15PubMed

151.

Schuster MG, Edwards JE Jr, Sobel JD et al (2008) Empirical fluconazole versus placebo for intensive care unit patients: a randomized trial. Ann Intern Med 149:83–90PubMed

152.

Senn L, Robinson JO, Schmidt S et al (2008) 1,3-Beta-D-glucan antigenemia for early diagnosis of invasive fungal infections in neutropenic patients with acute leukemia. Clin Infect Dis 46:878–885PubMed

153.

Shin JH, Kee SJ, Shin MG et al (2002) Biofilm production by isolates of Candida species recovered from nonneutropenic patients: comparison of bloodstream isolates with isolates from other sources. J Clin Microbiol 40:1244–1248PubMed

154.

Shorr AF, Lazarus DR, Sherner JH et al (2007) Do clinical features allow for accurate prediction of fungal pathogenesis in bloodstream infections? Potential implications of the increasing prevalence of non-albicans candidemia. Crit Care Med 35:1077–1083PubMed

155.

Singh N, Limaye AP, Forrest G et al (2006) Combination of voriconazole and caspofungin as primary therapy for invasive aspergillosis in solid organ transplant recipients: a prospective, multicenter, observational study. Transplantation 81:320–326PubMed

156.

Smego RA Jr, Perfect JR, Durack DT (1984) Combined therapy with amphotericin B and 5-fluorocytosine for Candida meningitis. Rev Infect Dis 6:791–801PubMed

157.

Solomkin JS, Mazuski JE, Baron EJ et al (2003) Guidelines for the selection of anti-infective agents for complicated intra-abdominal infections. Clin Infect Dis 37:997–1005PubMed

158.

Spellberg BJ, Filler SG, Edwards JE Jr (2006) Current treatment strategies for disseminated candidiasis. Clin Infect Dis 42:244–251PubMed

159.

Stevens DA, Lee JY (1997) Analysis of compassionate use itraconazole therapy for invasive aspergillosis by the NIAID Mycoses Study Group criteria. Arch Intern Med 157:1857–1862PubMed

160.

Storzinger D, Lichtenstern C, Swoboda S et al (2008) Posaconazole in intensive care patients I: invasive fungal infections in surgical intensive care and case presentation. Mycoses 51(Suppl 2):52–57PubMed

161.

Takakura S, Fujihara N, Saito T et al (2004) Clinical factors associated with fluconazole resistance and short-term survival in patients with Candida bloodstream infection. Eur J Clin Microbiol Infect Dis 23:380–388PubMed

162.

Taur Y, Bach P, Sepkowitz K (2008) Does candidemia really kill anyone? K-1394 In: ICAAC. Washington

163.

Torres HA, Hachem RY, Chemaly RF et al (2005) Posaconazole: a broad-spectrum triazole antifungal. Lancet Infect Dis 5:775–785PubMed

164.

Tortorano AM, Kibbler C, Peman J et al (2006) Candidaemia in Europe: epidemiology and resistance. Int J Antimicrob Agents 27:359–366PubMed

165.

Trick WE, Fridkin SK, Edwards JR et al (2002) Secular trend of hospital-acquired candidemia among intensive care unit patients in the United States during 1989–1999. Clin Infect Dis 35:627–630PubMed

166.

Trof RJ, Beishuizen A, Debets-Ossenkopp YJ et al (2007) Management of invasive pulmonary aspergillosis in non-neutropenic critically ill patients. Intensive Care Med 33:1694–1703PubMed

167.

Ullmann AJ, Lipton JH, Vesole DH et al (2007) Posaconazole or fluconazole for prophylaxis in severe graft-versus-host disease. N Engl J Med 356:335–347PubMed

168.

Vandewoude KH, Blot SI, Benoit D et al (2004) Invasive aspergillosis in critically ill patients: attributable mortality and excesses in length of ICU stay and ventilator dependence. J Hosp Infect 56:269–276PubMed

169.

Vandewoude KH, Blot SI, Depuydt P et al (2006) Clinical relevance of Aspergillus isolation from respiratory tract samples in critically ill patients. Crit Care 10:R31PubMed

170.

Vazquez JA, Skiest DJ, Nieto L et al (2006) A multicenter randomized trial evaluating posaconazole versus fluconazole for the treatment of oropharyngeal candidiasis in subjects with HIV/AIDS. Clin Infect Dis 42:1179–1186PubMed

171.

Vince A, Lepej SZ, Barsic B et al (2008) LightCycler SeptiFast assay as a tool for the rapid diagnosis of sepsis in patients during antimicrobial therapy. J Med Microbiol 57:1306–1307PubMed

172.

Vincent JL, Sakr Y, Sprung CL et al (2006) Sepsis in European intensive care units: results of the SOAP study. Crit Care Med 34:344–353PubMed

173.

Viscoli C (2007) O12. In: 3rd Trends in Medical Mycology. Turin

174.

Viscoli C, Girmenia C, Marinus A et al (1999) Candidemia in cancer patients: a prospective, multicenter surveillance study by the Invasive Fungal Infection Group (IFIG) of the European Organization for Research and Treatment of Cancer (EORTC). Clin Infect Dis 28:1071–1079PubMed

175.

Viscoli C, Machetti M, Cappellano P et al (2004) False-positive galactomannan platelia Aspergillus test results for patients receiving piperacillin-tazobactam. Clin Infect Dis 38:913–916PubMed

176.

Walsh TJ, Anaissie EJ, Denning DW et al (2008) Treatment of aspergillosis: clinical practice guidelines of the Infectious Diseases Society of America. Clin Infect Dis 46:327–360PubMed

177.

Walsh TJ, Finberg RW, Arndt C et al (1999) Liposomal amphotericin B for empirical therapy in patients with persistent fever and neutropenia. National Institute of Allergy and Infectious Diseases Mycoses Study Group. N Engl J Med 340:764–771PubMed

178.

Walsh TJ, Groll A, Hiemenz J et al (2004) Infections due to emerging and uncommon medically important fungal pathogens. Clin Microbiol Infect 10(Suppl 1):48–66PubMed

179.

Walsh TJ, Groll AH (2001) Overview: non-fumigatus species of Aspergillus: perspectives on emerging pathogens in immunocompromised hosts. Curr Opin Investig Drugs 2:1366–1367PubMed

180.

Walsh TJ, Hiemenz JW, Seibel NL et al (1998) Amphotericin B lipid complex for invasive fungal infections: analysis of safety and efficacy in 556 cases. Clin Infect Dis 26:1383–1396PubMed

181.

Walsh TJ, Pappas P, Winston DJ et al (2002) Voriconazole compared with liposomal amphotericin B for empirical antifungal therapy in patients with neutropenia and persistent fever. N Engl J Med 346:225–234PubMed

182.

Walsh TJ, Raad I, Patterson TF et al (2007) Treatment of invasive aspergillosis with posaconazole in patients who are refractory to or intolerant of conventional therapy: an externally controlled trial. Clin Infect Dis 44:2–12PubMed

183.

Walsh TJ, Teppler H, Donowitz GR et al (2004) Caspofungin versus liposomal amphotericin B for empirical antifungal therapy in patients with persistent fever and neutropenia. N Engl J Med 351:1391–1402PubMed

184.

Wilson DA, Joyce MJ, Hall LS et al (2005) Multicenter evaluation of a Candida albicans peptide nucleic acid fluorescent in situ hybridization probe for characterization of yeast isolates from blood cultures. J Clin Microbiol 43:2909–2912PubMed

185.

Wingard JR (1995) Importance of Candida species other than C. albicans as pathogens in oncology patients. Clin Infect Dis 20:115–125PubMed

186.

Wingard JR, Kubilis P, Lee L et al (1999) Clinical significance of nephrotoxicity in patients treated with amphotericin B for suspected or proven aspergillosis. Clin Infect Dis 29:1402–1407PubMed

187.

Wisplinghoff H, Bischoff T, Tallent SM et al (2004) Nosocomial bloodstream infections in US hospitals: analysis of 24,179 cases from a prospective nationwide surveillance study. Clin Infect Dis 39:309–317PubMed

188.

Wood GC, Mueller EW, Croce MA et al (2006) Candida sp. isolated from bronchoalveolar lavage: clinical significance in critically ill trauma patients. Intensive Care Med 32:599–603PubMed

189.

Woods G, Miceli MH, Grazziutti ML et al (2007) Serum Aspergillus galactomannan antigen values strongly correlate with outcome of invasive aspergillosis: a study of 56 patients with hematologic cancer. Cancer 110:830–834PubMed

190.

Yeo SF, Wong B (2002) Current status of nonculture methods for diagnosis of invasive fungal infections. Clin Microbiol Rev 15:465–484PubMed

Titel: Update: invasive Pilzinfektionen
Diagnose und Therapie in der operativen Intensivmedizin
verfasst von: Dr. C. Lichtenstern
S. Swoboda
M. Hirschburger
E. Domann
T. Hoppe-Tichy
M. Winkler
C. Lass-Flörl
M.A. Weigand
Publikationsdatum: 01.01.2010
Verlag: Springer-Verlag
Erschienen in: Die Anaesthesiologie / Ausgabe 1/2010
Print ISSN: 2731-6858
Elektronische ISSN: 2731-6866
DOI: https://doi.org/10.1007/s00101-009-1655-4

Neu im Fachgebiet AINS

Blutdrucksenkung schon im Rettungswagen bei akutem Schlaganfall?

31.05.2024 Apoplex Nachrichten

Der optimale Ansatz für die Blutdruckkontrolle bei Patientinnen und Patienten mit akutem Schlaganfall ist noch nicht gefunden. Ob sich eine frühzeitige Therapie der Hypertonie noch während des Transports in die Klinik lohnt, hat jetzt eine Studie aus China untersucht.

Nicht Creutzfeldt Jakob, sondern Abführtee-Vergiftung

29.05.2024 Hyponatriämie Nachrichten

Eine ältere Frau trinkt regelmäßig Sennesblättertee gegen ihre Verstopfung. Der scheint plötzlich gut zu wirken. Auf Durchfall und Erbrechen folgt allerdings eine Hyponatriämie. Nach deren Korrektur kommt es plötzlich zu progredienten Kognitions- und Verhaltensstörungen.

Häusliche Gewalt in der orthopädischen Notaufnahme oft nicht erkannt

28.05.2024 Häusliche Gewalt Nachrichten

In der Notaufnahme wird die Chance, Opfer von häuslicher Gewalt zu identifizieren, von Orthopäden und Orthopädinnen offenbar zu wenig genutzt. Darauf deuten die Ergebnisse einer Fragebogenstudie an der Sahlgrenska-Universität in Schweden hin.

Update AINS

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

hier abonnieren

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Update: invasive Pilzinfektionen

Diagnose und Therapie in der operativen Intensivmedizin

Zusammenfassung

Neu im Fachgebiet AINS

Blutdrucksenkung schon im Rettungswagen bei akutem Schlaganfall?

Ähnliche Überlebensraten nach Reanimation während des Transports bzw. vor Ort

Nicht Creutzfeldt Jakob, sondern Abführtee-Vergiftung

Häusliche Gewalt in der orthopädischen Notaufnahme oft nicht erkannt

Update AINS

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Zusammenfassung

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 1/2010

Neurologische Komplikation nach einer vertikalen infraklavikulären Plexusblockade

Ausbreitung hyperbarer Lokalanästhetika im Spinalkanalmodell

Ultraschallgestützte zentrale Venenpunktion bei Erwachsenen und Kindern

Neue (Querschnitt-)Leitlinien der Bundesärztekammer für die Hämotherapie mit gefrorenem Frischplasma

Alte und neue Gerinnungshemmer

Neue Influenza-A/H1N1-2009-Virus-Pandemie

Neu im Fachgebiet AINS

Blutdrucksenkung schon im Rettungswagen bei akutem Schlaganfall?

Ähnliche Überlebensraten nach Reanimation während des Transports bzw. vor Ort

Nicht Creutzfeldt Jakob, sondern Abführtee-Vergiftung

Häusliche Gewalt in der orthopädischen Notaufnahme oft nicht erkannt

Update AINS