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Risk factors for Candidaemia

Case study 2: Disseminated candida. What are the risks factors for candidaemia?

Invasive Candidosis = deep seated infection of tissues or organs by one of the Candida species

Candidaemia = proven or probable bloodstream infection by one of the Candida species (a form of Invasive Candidosis).

Candida under the microscope

Candida is an increasingly important cause of systemic infection. In developed economies, it is the most common invasive fungal infection seen in hospitalised patients.

It is associated with high mortality (up to 50%), especially when effective treatment is delayed. There are also associated diagnostic challenges, which leave it often unrecognised.

In order to recognise this infection, clinicians need a high index of suspicion. An understanding of at-risk patient groups helps us to identify those in need of diagnostic testing and empirical treatment.

Risk factors for developing candidaemia are listed below:

  • ICU admission
  • Recent abdominal (especially bowel) surgery
  • Central venous catheter
  • Total parenteral nutrition
  • Immunosuppression (haematological malignancy, steroids, chemotherapy)
  • Diabetes
  • Haemodialysis
  • Broad spectrum antibiotic use

This list is not exhaustive, and a more comprehensive set of risk factors can be found here.

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The Role of Antifungal Stewardship

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