ESCMID* guideline for the diagnosis and management of Candida diseases 2012: non-neutropenic adult patients

被引：932

作者：

Cornely, O. A. ^{[1
,28
]}

Bassetti, M. ^{[2
]}

Calandra, T. ^{[3
,4
]}

Garbino, J. ^{[5
]}

Kullberg, B. J. ^{[6
]}

Lortholary, O. ^{[7
,8
]}

Meersseman, W. ^{[9
]}

Akova, M. ^{[10
]}

Arendrup, M. C. ^{[11
]}

Arikan-Akdagli, S. ^{[12
]}

Bille, J. ^{[4
]}

Castagnola, E. ^{[13
]}

Cuenca-Estrella, M. ^{[14
]}

Donnelly, J. P. ^{[6
]}

Groll, A. H. ^{[5
,15
,16
]}

Herbrecht, R. ^{[17
]}

Hope, W. W. ^{[18
]}

Jensen, H. E. ^{[19
]}

Lass-Floerl, C. ^{[20
]}

Petrikkos, G. ^{[21
]}

Richardson, M. D. ^{[22
,23
]}

Roilides, E. ^{[24
,25
]}

Verweij, P. E. ^{[6
]}

Viscoli, C. ^{[26
]}

Ullmann, A. J. ^{[27
]}

机构：

[1] Univ Cologne, Dept Internal Med 1,German Ctr Infect Res, Clin Trials Ctr Cologne,ZKS Koln,Cologne Excellen, BMBF 01KN1106,Ctr Integrated Oncol CIO KolnBonn, D-50924 Cologne, Germany

[2] Santa Maria Misericordia Univ Hosp, Udine, Italy

[3] CHU Vaudois, Dept Med, Infect Dis Serv, CH-1011 Lausanne, Switzerland

[4] Univ Lausanne, Lausanne, Switzerland

[5] Univ Hosp Geneva, Geneva, Switzerland

[6] Radboud Univ Nijmegen Med Ctr, NL-6525 ED Nijmegen, Netherlands

[7] Univ Paris 05, Hop Necker Enfants Malad, APHP,IHU Imagine, Serv Malad Infect & Trop,Ctr Infectiol Necker Pas, Paris, France

[8] Inst Pasteur, CNRS, URA3012, Ctr Natl Reference Mycol & Antifong,Unite Mycol M, Paris, France

[9] Univ Hosp Gasthuisberg, B-3000 Louvain, Belgium

[10] Hacettepe Univ Sch Med, Dept Med, Ankara, Turkey

[11] Statens Serum Inst, DK-2300 Copenhagen, Denmark

[12] Hacettepe Univ Sch Med, Dept Med Microbiol, Ankara, Turkey

[13] Childrens Hosp, Inst Giannina Gaslini, Genoa, Italy

[14] Inst Salud Carlos III, Ctr Nacl Microbiol, Madrid, Spain

[15] Univ Childrens Hosp, Ctr Bone Marrow Transplantat, Munster, Germany

[16] Univ Childrens Hosp, Dept Pediat Hematol Oncol, Munster, Germany

[17] Univ Strasbourg, Hop Hautepierre, Strasbourg, France

[18] Univ Liverpool, Dept Mol & Clin Pharmacol, Antimicrobial Pharmacodynam & Therapeut, Liverpool L69 3BX, Merseyside, England

[19] Univ Copenhagen, Frederiksberg, Denmark

[20] Innsbruck Med Univ, Div Hyg & Med Microbiol, Innsbruck, Austria

[21] Natl & Kapodistrian Univ Athens, Dept Internal Med 4, Athens 11528, Greece

[22] Univ Hosp South Manchester, Mycol Reference Ctr, Manchester M20 8LR, Lancs, England

[23] Univ Manchester, Manchester Acad Hlth Sci Ctr, Manchester, Lancs, England

[24] Aristotelian Univ Sch Med, Dept Pediat 3, GR-54006 Thessaloniki, Greece

[25] Hippokrateion Hosp, Thessaloniki, Greece

[26] Univ Genoa, IRCCS San Martino IST, Genoa, Italy

[27] Julius Maximilians Univ, Dept Internal Med 2, Oberdurrbacher Str 6, D-97080 Wurzburg, Germany

[28] Univ Cologne, Dept Internal Med 1, D-50924 Cologne, Germany

来源：

CLINICAL MICROBIOLOGY AND INFECTION | 2012年 / 18卷

基金：

英国医学研究理事会;

关键词：

Candidiasis; Guideline; non-neutropenic; prophylaxis; treatment; INTENSIVE-CARE-UNIT; LIPOSOMAL AMPHOTERICIN-B; ENDOGENOUS FUNGAL ENDOPHTHALMITIS; CRITICALLY-ILL PATIENTS; PLACEBO-CONTROLLED TRIAL; CENTRAL VENOUS CATHETER; BLOOD-STREAM INFECTION; BETA-D-GLUCAN; DOUBLE-BLIND; INVASIVE CANDIDIASIS;

D O I：

10.1111/1469-0691.12039

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

Clin Microbiol Infect 2012; 18 (Suppl. 7): 1937 Abstract This part of the EFISG guidelines focuses on non-neutropenic adult patients. Only a few of the numerous recommendations can be summarized in the abstract. Prophylactic usage of fluconazole is supported in patients with recent abdominal surgery and recurrent gastrointestinal perforations or anastomotic leakages. Candida isolation from respiratory secretions alone should never prompt treatment. For the targeted initial treatment of candidaemia, echinocandins are strongly recommended while liposomal amphotericin B and voriconazole are supported with moderate, and fluconazole with marginal strength. Treatment duration for candidaemia should be a minimum of 14 days after the end of candidaemia, which can be determined by one blood culture per day until negativity. Switching to oral treatment after 10 days of intravenous therapy has been safe in stable patients with susceptible Candida species. In candidaemia, removal of indwelling catheters is strongly recommended. If catheters cannot be removed, lipid-based amphotericin B or echinocandins should be preferred over azoles. Transoesophageal echocardiography and fundoscopy should be performed to detect organ involvement. Native valve endocarditis requires surgery within a week, while in prosthetic valve endocarditis, earlier surgery may be beneficial. The antifungal regimen of choice is liposomal amphotericin B +/- flucytosine. In ocular candidiasis, liposomal amphotericin B +/- flucytosine is recommended when the susceptibility of the isolate is unknown, and in susceptible isolates, fluconazole and voriconazole are alternatives. Amphotericin B deoxycholate is not recommended for any indication due to severe side effects.

引用

页码：19 / 37

页数：19

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