Journal ArticleDOI
Fungal infection in surgical patients
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Invasive fungal infections have become a major source of morbidity and mortality in the modern surgical intensive care unit (SICU), and early systemic treatment is warranted as mentioned in this paper, however, for the most critically ill patient amphotericin B remains the treatment of choice.Abstract:
Invasive fungal infections have become a major source of morbidity and mortality in the modern surgical intensive care unit. Patients at risk for invasion and dissemination are common, and are not as ill as thought previously. Severity of illness (APACHE II score >10, ventilator use for >48 hours), antibiotics, central venous lines, total parenteral nutrition, burns, and immunosuppression are the most common risk factors. Recognition of these risk factors should arouse a high index of suspicion for the diagnosis of invasion or dissemination. Unfortunately, laboratory tests alone lack sensitivity and specificity. Therefore, the diagnosis of invasion and dissemination in the majority of cases requires the acquisition and proper interpretation of clinical evidence. Once the diagnosis is made, early systemic treatment is warranted. Reported toxicity and efficacy supports the use of fluconazole for most patients with invasive fungal infections. However, for the most critically ill patient amphotericin B remains the treatment of choice.read more
Citations
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Journal ArticleDOI
Emerging infections in burns.
Ludwik K. Branski,Ahmed M. Al-Mousawi,Haidy G. Rivero,Marc G. Jeschke,Arthur P. Sanford,David N. Herndon +5 more
TL;DR: Innovations in fluid management, ventilatory support, surgical care, and antimicrobial therapy have contributed to a significant reduction in morbidity and mortality rates in burn patients.
Journal ArticleDOI
Candidemia in non-neutropenic critically ill patients: analysis of prognostic factors and assessment of systemic antifungal therapy
Juan Nolla-Salas,Antonio Sitges-Serra,C León-Gil,J Martínez-González,M. A. León-Regidor,P Ibáñez-Lucía,J. M. Torres-Rodríguez +6 more
TL;DR: The incidence of candidemia in ICU patients was very low and patients with “early” antifungal therapy had a higher probability of survival compared with patients with late therapy, and no significant differences were noted between the two groups on different antifundal therapy.
Journal ArticleDOI
One stop mycology
TL;DR: This listing covers the period May 1, 1997 through to June 30, 1997, which roughly corresponds with the British Mycological Society's Special Interest Committees.
Journal ArticleDOI
Antimicrobial Activity Of Some Indian Medicinal Plants
Rajesh Dabur,Amita Gupta,T. K. Mandal,Desh Deepak Singh,Vivek K. Bajpai,A M Gurav,G S Lavekar +6 more
TL;DR: Water extracts of Acacia nilotica, Justicia zelanica, Lantana camara and Saraca asoca exhibited good activity against all the bacteria tested and the MIC was recorded in range of 9.375-37.5 microg/ml.
Journal ArticleDOI
Significance of Candida recovered from intraoperative specimens in patients with intra-abdominal perforations.
TL;DR: The recovery rate of yeast from intraoperative specimens from the abdominal cavity was high and was associated with death and a complicated postoperative course, and detection of yeast was also a significant explanatory variable for a prolonged period of mechanical ventilation, intensive care treatment, and prolonged use of a central venous catheter.
References
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Journal ArticleDOI
Secular Trends in the Epidemiology of Nosocomial Fungal Infections in the United States, 1980–1990
TL;DR: Fungi are emerging as important nosocomial pathogens and control efforts should target fungal infections, especially fungemia, which has increased at all four major anatomic sites of infection.
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A Controlled Trial of Fluconazole to Prevent Fungal Infections in Patients Undergoing Bone Marrow Transplantation
Jesse L. Goodman,Drew J. Winston,Ronald A. Greenfield,Pranatharthi H. Chandrasekar,Barry C. Fox,Herbert Kaizer,Richard K. Shadduck,Thomas C. Shea,Patrick J. Stiff,David J. Friedman,William G. Powderly,Jeffrey L. Silber,Harold W. Horowitz,Alan E. Lichtin,Steven N. Wolff,Mangan Kf,Samuel M. Silver,Daniel J. Weisdorf,Winston G. Ho,Gene S. Gilbert,Donald N. Buell +20 more
TL;DR: Prophylactic administration of fluconazole to recipients of bone marrow transplants reduces the incidence of both systemic and superficial fungal infections.
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A Randomized Trial Comparing Fluconazole with Amphotericin B for the Treatment of Candidemia in Patients without Neutropenia
John H. Rex,John E. Bennett,Alan M. Sugar,Peter G. Pappas,Charles van der Horst,John E. Edwards,Ronald G. Washburn,W. Michael Scheld,Adolf W. Karchmer,Alan P. Dine,Marcia Levenstein,C. Douglas Webb +11 more
TL;DR: A multicenter randomized trial that compared amphotericin B with fluconazole as treatment for candidemia, with the most common diagnoses being renal failure, nonhematologic cancer, and gastrointestinal disease.
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Increase in Candida krusei Infection among Patients with Bone Marrow Transplantation and Neutropenia Treated Prophylactically with Fluconazole
John R. Wingard,William G. Merz,Michael G. Rinaldi,Thomas R. Johnson,Judith E. Karp,Rein Saral +5 more
TL;DR: In patients at high risk for disseminated candida infections, suppression of bacterial flora and the more common candida pathogens may permit some less pathogenic, but natively resistant candida species, such as C. krusei, to emerge as systemic pathogens.
Journal ArticleDOI
Hospital-Acquired Candidemia: The Attributable Mortality and Excess Length of Stay
TL;DR: Candida bloodstream infections represented 10% of all nosocomial bloodstream infections in the period studied at the University Hospital; they are associated with a significant medical and economic burden well above that expected of the underlying diseases alone.