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. 1996 Nov-Dec;69(6):505–515.

Systemic Candida infections.

L A Grohskopf 1, V T Andriole 1
PMCID: PMC2589037  PMID: 9436294

Abstract

Over the past two decades, Candida species have come to be regarded as important agents of nosocomial infection. In this paper, initially presented as a teaching conference at the Yale University School of Medicine, we summarize recent information pertaining to the epidemiology, diagnosis, and treatment of systemic Candida infections.

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Selected References

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  1. Anaissie E., Bodey G. P., Kantarjian H., David C., Barnett K., Bow E., Defelice R., Downs N., File T., Karam G. Fluconazole therapy for chronic disseminated candidiasis in patients with leukemia and prior amphotericin B therapy. Am J Med. 1991 Aug;91(2):142–150. doi: 10.1016/0002-9343(91)90006-j. [DOI] [PubMed] [Google Scholar]
  2. Banerjee S. N., Emori T. G., Culver D. H., Gaynes R. P., Jarvis W. R., Horan T., Edwards J. R., Tolson J., Henderson T., Martone W. J. Secular trends in nosocomial primary bloodstream infections in the United States, 1980-1989. National Nosocomial Infections Surveillance System. Am J Med. 1991 Sep 16;91(3B):86S–89S. doi: 10.1016/0002-9343(91)90349-3. [DOI] [PubMed] [Google Scholar]
  3. Bayer A. S., Blumenkrantz M. J., Montgomerie J. Z., Galpin J. E., Coburn J. W., Guze L. B. Candida peritonitis. Report of 22 cases and review of the English literature. Am J Med. 1976 Dec;61(6):832–840. doi: 10.1016/0002-9343(76)90407-1. [DOI] [PubMed] [Google Scholar]
  4. Beck-Sagué C., Jarvis W. R. Secular trends in the epidemiology of nosocomial fungal infections in the United States, 1980-1990. National Nosocomial Infections Surveillance System. J Infect Dis. 1993 May;167(5):1247–1251. doi: 10.1093/infdis/167.5.1247. [DOI] [PubMed] [Google Scholar]
  5. Berenguer J., Buck M., Witebsky F., Stock F., Pizzo P. A., Walsh T. J. Lysis-centrifugation blood cultures in the detection of tissue-proven invasive candidiasis. Disseminated versus single-organ infection. Diagn Microbiol Infect Dis. 1993 Aug-Sep;17(2):103–109. doi: 10.1016/0732-8893(93)90020-8. [DOI] [PubMed] [Google Scholar]
  6. Diasio R. B., Bennett J. E., Myers C. E. Mode of action of 5-fluorocytosine. Biochem Pharmacol. 1978 Mar 1;27(5):703–707. doi: 10.1016/0006-2952(78)90507-5. [DOI] [PubMed] [Google Scholar]
  7. Diasio R. B., Lakings D. E., Bennett J. E. Evidence for conversion of 5-fluorocytosine to 5-fluorouracil in humans: possible factor in 5-fluorocytosine clinical toxicity. Antimicrob Agents Chemother. 1978 Dec;14(6):903–908. doi: 10.1128/aac.14.6.903. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Edwards J. E., Jr, Filler S. G. Current strategies for treating invasive candidiasis: emphasis on infections in nonneutropenic patients. Clin Infect Dis. 1992 Mar;14 (Suppl 1):S106–S113. doi: 10.1093/clinids/14.supplement_1.s106. [DOI] [PubMed] [Google Scholar]
  9. Emori T. G., Culver D. H., Horan T. C., Jarvis W. R., White J. W., Olson D. R., Banerjee S., Edwards J. R., Martone W. J., Gaynes R. P. National nosocomial infections surveillance system (NNIS): description of surveillance methods. Am J Infect Control. 1991 Feb;19(1):19–35. doi: 10.1016/0196-6553(91)90157-8. [DOI] [PubMed] [Google Scholar]
  10. Flannery M. T., Simmons D. B., Saba H., Altus P., Wallach P. M., Adelman H. M. Fluconazole in the treatment of hepatosplenic candidiasis. Arch Intern Med. 1992 Feb;152(2):406–408. [PubMed] [Google Scholar]
  11. Fraser V. J., Jones M., Dunkel J., Storfer S., Medoff G., Dunagan W. C. Candidemia in a tertiary care hospital: epidemiology, risk factors, and predictors of mortality. Clin Infect Dis. 1992 Sep;15(3):414–421. doi: 10.1093/clind/15.3.414. [DOI] [PubMed] [Google Scholar]
  12. Garner J. S., Jarvis W. R., Emori T. G., Horan T. C., Hughes J. M. CDC definitions for nosocomial infections, 1988. Am J Infect Control. 1988 Jun;16(3):128–140. doi: 10.1016/0196-6553(88)90053-3. [DOI] [PubMed] [Google Scholar]
  13. Haron E., Feld R., Tuffnell P., Patterson B., Hasselback R., Matlow A. Hepatic candidiasis: an increasing problem in immunocompromised patients. Am J Med. 1987 Jul;83(1):17–26. doi: 10.1016/0002-9343(87)90492-x. [DOI] [PubMed] [Google Scholar]
  14. Hoeprich P. D. Clinical use of amphotericin B and derivatives: lore, mystique, and fact. Clin Infect Dis. 1992 Mar;14 (Suppl 1):S114–S119. doi: 10.1093/clinids/14.supplement_1.s114. [DOI] [PubMed] [Google Scholar]
  15. Jakab K., Kelemen E., Prinz G., Török I. Amphotericin-resistant invasive hepatosplenic candidiasis controlled by fluconazole. Lancet. 1990 Feb 24;335(8687):473–474. doi: 10.1016/0140-6736(90)90706-b. [DOI] [PubMed] [Google Scholar]
  16. Kan V. L. Polymerase chain reaction for the diagnosis of candidemia. J Infect Dis. 1993 Sep;168(3):779–783. doi: 10.1093/infdis/168.3.779. [DOI] [PubMed] [Google Scholar]
  17. Kauffman C. A., Bradley S. F., Ross S. C., Weber D. R. Hepatosplenic candidiasis: successful treatment with fluconazole. Am J Med. 1991 Aug;91(2):137–141. doi: 10.1016/0002-9343(91)90005-i. [DOI] [PubMed] [Google Scholar]
  18. Kline S., Larsen T. A., Fieber L., Fishbach R., Greenwood M., Harris R., Kline M. W., Tennican P. O., Janoff E. N. Limited toxicity of prolonged therapy with high doses of amphotericin B lipid complex. Clin Infect Dis. 1995 Nov;21(5):1154–1158. doi: 10.1093/clinids/21.5.1154. [DOI] [PubMed] [Google Scholar]
  19. Lopez-Berestein G., Bodey G. P., Fainstein V., Keating M., Frankel L. S., Zeluff B., Gentry L., Mehta K. Treatment of systemic fungal infections with liposomal amphotericin B. Arch Intern Med. 1989 Nov;149(11):2533–2536. [PubMed] [Google Scholar]
  20. Lopez-Berestein G., Bodey G. P., Frankel L. S., Mehta K. Treatment of hepatosplenic candidiasis with liposomal-amphotericin B. J Clin Oncol. 1987 Feb;5(2):310–317. doi: 10.1200/JCO.1987.5.2.310. [DOI] [PubMed] [Google Scholar]
  21. Lopez-Berestein G., Fainstein V., Hopfer R., Mehta K., Sullivan M. P., Keating M., Rosenblum M. G., Mehta R., Luna M., Hersh E. M. Liposomal amphotericin B for the treatment of systemic fungal infections in patients with cancer: a preliminary study. J Infect Dis. 1985 Apr;151(4):704–710. doi: 10.1093/infdis/151.4.704. [DOI] [PubMed] [Google Scholar]
  22. Marsh P. K., Tally F. P., Kellum J., Callow A., Gorbach S. L. Candida infections in surgical patients. Ann Surg. 1983 Jul;198(1):42–47. doi: 10.1097/00000658-198307000-00008. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Meunier-Carpentier F., Kiehn T. E., Armstrong D. Fungemia in the immunocompromised host. Changing patterns, antigenemia, high mortality. Am J Med. 1981 Sep;71(3):363–370. doi: 10.1016/0002-9343(81)90162-5. [DOI] [PubMed] [Google Scholar]
  24. Murray P. R. Comparison of the lysis-centrifugation and agitated biphasic blood culture systems for detection of fungemia. J Clin Microbiol. 1991 Jan;29(1):96–98. doi: 10.1128/jcm.29.1.96-98.1991. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Oppenheim B. A., Herbrecht R., Kusne S. The safety and efficacy of amphotericin B colloidal dispersion in the treatment of invasive mycoses. Clin Infect Dis. 1995 Nov;21(5):1145–1153. doi: 10.1093/clinids/21.5.1145. [DOI] [PubMed] [Google Scholar]
  26. Pappagianis D., Collins M. S., Hector R., Remington J. Development of resistance to amphotericin B in Candida lusitaniae infecting a human. Antimicrob Agents Chemother. 1979 Aug;16(2):123–126. doi: 10.1128/aac.16.2.123. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Pittet D., Wenzel R. P. Nosocomial bloodstream infections. Secular trends in rates, mortality, and contribution to total hospital deaths. Arch Intern Med. 1995 Jun 12;155(11):1177–1184. doi: 10.1001/archinte.155.11.1177. [DOI] [PubMed] [Google Scholar]
  28. Plouffe J. F., Brown D. G., Silva J., Jr, Eck T., Stricof R. L., Fekety F. R., Jr Nosocomial outbreak of Candida parapsilosis fungemia related to intravenous infusions. Arch Intern Med. 1977 Dec;137(12):1686–1689. [PubMed] [Google Scholar]
  29. Price M. F., LaRocco M. T., Gentry L. O. Fluconazole susceptibilities of Candida species and distribution of species recovered from blood cultures over a 5-year period. Antimicrob Agents Chemother. 1994 Jun;38(6):1422–1424. doi: 10.1128/aac.38.6.1422. [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. Reef S. E., Mayer K. H. Opportunistic candidal infections in patients infected with human immunodeficiency virus: prevention issues and priorities. Clin Infect Dis. 1995 Aug;21 (Suppl 1):S99–102. doi: 10.1093/clinids/21.supplement_1.s99. [DOI] [PubMed] [Google Scholar]
  31. Rex J. H., Bennett J. E., Sugar A. M., Pappas P. G., Serody J., Edwards J. E., Washburn R. G. Intravascular catheter exchange and duration of candidemia. NIAID Mycoses Study Group and the Candidemia Study Group. Clin Infect Dis. 1995 Oct;21(4):994–996. doi: 10.1093/clinids/21.4.994. [DOI] [PubMed] [Google Scholar]
  32. Rex J. H., Bennett J. E., Sugar A. M., Pappas P. G., van der Horst C. M., Edwards J. E., Washburn R. G., Scheld W. M., Karchmer A. W., Dine A. P. 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. 1994 Nov 17;331(20):1325–1330. doi: 10.1056/NEJM199411173312001. [DOI] [PubMed] [Google Scholar]
  33. Stamm A. M., Diasio R. B., Dismukes W. E., Shadomy S., Cloud G. A., Bowles C. A., Karam G. H., Espinel-Ingroff A. Toxicity of amphotericin B plus flucytosine in 194 patients with cryptococcal meningitis. Am J Med. 1987 Aug;83(2):236–242. doi: 10.1016/0002-9343(87)90691-7. [DOI] [PubMed] [Google Scholar]
  34. Swerdloff J. N., Filler S. G., Edwards J. E., Jr Severe candidal infections in neutropenic patients. Clin Infect Dis. 1993 Nov;17 (Suppl 2):S457–S467. doi: 10.1093/clinids/17.supplement_2.s457. [DOI] [PubMed] [Google Scholar]
  35. Tang C. Successful treatment of Candida albicans osteomyelitis with fluconazole. J Infect. 1993 Jan;26(1):89–92. doi: 10.1016/0163-4453(93)97064-5. [DOI] [PubMed] [Google Scholar]
  36. Telenti A., Steckelberg J. M., Stockman L., Edson R. S., Roberts G. D. Quantitative blood cultures in candidemia. Mayo Clin Proc. 1991 Nov;66(11):1120–1123. doi: 10.1016/s0025-6196(12)65791-7. [DOI] [PubMed] [Google Scholar]
  37. Terrell C. L., Hughes C. E. Antifungal agents used for deep-seated mycotic infections. Mayo Clin Proc. 1992 Jan;67(1):69–91. doi: 10.1016/s0025-6196(12)60281-x. [DOI] [PubMed] [Google Scholar]
  38. Thaler M., Pastakia B., Shawker T. H., O'Leary T., Pizzo P. A. Hepatic candidiasis in cancer patients: the evolving picture of the syndrome. Ann Intern Med. 1988 Jan;108(1):88–100. doi: 10.7326/0003-4819-108-1-88. [DOI] [PubMed] [Google Scholar]
  39. Tucker R. M., Williams P. L., Arathoon E. G., Levine B. E., Hartstein A. I., Hanson L. H., Stevens D. A. Pharmacokinetics of fluconazole in cerebrospinal fluid and serum in human coccidioidal meningitis. Antimicrob Agents Chemother. 1988 Mar;32(3):369–373. doi: 10.1128/aac.32.3.369. [DOI] [PMC free article] [PubMed] [Google Scholar]
  40. Tunkel A. R., Thomas C. Y., Wispelwey B. Candida prosthetic arthritis: report of a case treated with fluconazole and review of the literature. Am J Med. 1993 Jan;94(1):100–103. doi: 10.1016/0002-9343(93)90127-b. [DOI] [PubMed] [Google Scholar]
  41. Urbak S. F., Degn T. Fluconazole in the treatment of candida albicans endophthalmitis. Acta Ophthalmol (Copenh) 1992 Aug;70(4):528–529. doi: 10.1111/j.1755-3768.1992.tb02126.x. [DOI] [PubMed] [Google Scholar]
  42. Venditti M., De Bernardis F., Micozzi A., Pontieri E., Chirletti P., Cassone A., Martino P. Fluconazole treatment of catheter-related right-sided endocarditis caused by Candida albicans and associated with endophthalmitis and folliculitis. Clin Infect Dis. 1992 Feb;14(2):422–426. doi: 10.1093/clinids/14.2.422. [DOI] [PubMed] [Google Scholar]
  43. Wey S. B., Mori M., Pfaller M. A., Woolson R. F., Wenzel R. P. Hospital-acquired candidemia. The attributable mortality and excess length of stay. Arch Intern Med. 1988 Dec;148(12):2642–2645. doi: 10.1001/archinte.148.12.2642. [DOI] [PubMed] [Google Scholar]
  44. Wingard J. R., Merz W. G., Rinaldi M. G., Johnson T. R., Karp J. E., Saral R. Increase in Candida krusei infection among patients with bone marrow transplantation and neutropenia treated prophylactically with fluconazole. N Engl J Med. 1991 Oct 31;325(18):1274–1277. doi: 10.1056/NEJM199110313251803. [DOI] [PubMed] [Google Scholar]
  45. Wingard J. R., Merz W. G., Saral R. Candida tropicalis: a major pathogen in immunocompromised patients. Ann Intern Med. 1979 Oct;91(4):539–543. doi: 10.7326/0003-4819-91-4-539. [DOI] [PubMed] [Google Scholar]
  46. de Repentigny L. Serodiagnosis of candidiasis, aspergillosis, and cryptococcosis. Clin Infect Dis. 1992 Mar;14 (Suppl 1):S11–S22. doi: 10.1093/clinids/14.supplement_1.s11. [DOI] [PubMed] [Google Scholar]

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