Course: The Role of Antifungal Stewardship

Aspergillus species are environmental moulds which are ubiquitous. We all inhale hundreds of Aspergillus spores daily. Above, Stained microscopy slide showing Aspergillus fumigatus in a lung alveolus Multiple conditions can …

This was a case of Richard Wilson, a 54-year old man who attended the Emergency Department with signs and symptoms of urinary sepsis requiring ICU admission, and who deteriorated clinically …

The medical team decide to treat this patient with empirical antifungal therapy. They suspect he may have developed candidaemia during his ICU admission. His background of type 2 diabetes, indwelling …

What antifungal stewardship approaches could be used to prevent overuse of antifungals in the ICUs? What diagnostics are available and how should these be used? β-1-3-D-glucan Has good sensitivity for …

Part of the challenge that fungal infections pose is that confirming a diagnosis can be difficult. If candidaemia is suspected, empirical treatment is indicated. This principle is based on the …

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 …

Richard Wilson, a 54-year old man presents to the Emergency Department. He has a 3-day history of fever, tiredness and feeling generally unwell. His medical background is significant for Type …

We are now familiar with the main classes of antifungals. But how do we use them appropriately? Antimicrobial stewardship aims to reduce unnecessary and inappropriate prescribing and to minimize the …

Antifungals are antimicrobials too Antimicrobials are drugs aimed at killing non-human organisms within the body. Antibiotics are used against bacteria and are subject to wide-reaching stewardship programmes. Antifungals are also …

Fungal biomarker testing Detection of fungal antigens (biomarkers) in sterile site samples is often the most sensitive method to confirm or to rule out the presence of invasive fungal infection. …

Fungal infections can be a diagnostic challenge resulting in overuse of antifungals. This is particularly the case with systemic fungal infections with high mortality. A spectrum of diagnostic tests is …

Subcutaneous mycoses Subcutaneous fungal infections extend from the lower skin layers down to the bone. They almost always result from inoculation via a break in the skin surface (trauma). Inoculation …

It is important to understand how fungi cause disease in order to know how to prevent the development of infection and to control its source when infection has already developed. …

Introduction to fungal infections Fungal infections in humans can be broadly divided into (i) superficial skin and mucosal infections and (ii) deep or systemic infections. Superficial infections do not necessarily …