Title Fungal infections in the intensive care unit Title (croatian) Gljivične infekcije u jedinici intenzivnog liječenja Author Dajana Džeko Mentor Tajana Zah Bogović (mentor)Committee member Tajana Zah Bogović (predsjednik povjerenstva)Committee member Mladen Perić (član povjerenstva)Committee member DINKO TONKOVIĆ (član povjerenstva)Granter University of Zagreb Defense date and country 2017-07-14, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Scientific / art field, BIOMEDICINE AND HEALTHCARE Scientific / art field, BIOMEDICINE AND HEALTHCARE Abstract BACKGROUND AND AIMS: Treating infections in patients at the intensive care unit is a complex matter which is nevertheless complicated by the critical state that the patients are usually in. The mortality rate due to fungal infections haven’t changed much in the last few years and so; dealing with fungal infections in the setting of critically ill patients can be challenging and there is an ongoing need for more research and for the development of new approaches. While previous discoveries of antifungal drugs were deemed successful in treatment, they created room for emergence of new fungal species and the widespread use of antibiotics and antifungal drugs has led to a growing resistance. Difficulties with early detection of fungal infections are currently still problematic while it has been shown to be crucial for the success of the treatment. With a shift in species and emerging resistance, while diagnostics and mortality rates aren’t getting much better; new approaches to fungal infections in the ICU (Intensive Care Unit) are being sought for. ----- METHODS: PubMed and Google Scholar were used to find relevant material. Search terms included, but were not limited to: Invasive Candidiasis, ICU, treatment, Aspergillosis, risk factors etc. The primary criteria for study selection were evidence-based research and quality of design. ----- FINDINGS: Predictive rules to select high-risk patients who might benefit from prophylactic antifungal therapy have been found to be successful when used in combination with a clinical suspicion of fungal infection; but still need to be incorporated into clinical praxis. New diagnostic techniques (β-D-glucan, PCR) are under development and would lead to faster recognition of patients with fungal infections and hence faster administration of treatment; which has been shown to positively affect the survival rate.The recommended treatment has changed toward newer antifungal drugs, but also depend on the age of the patient, immune status, localization of infection and isolated fungal species.
Abstract (croatian) POZADINA I CILJEVI: Liječenje infekcija kod pacijenata u jedinici intenzivnog liječenja je složeno, a dodatno se komplicira životno ugrožavajućim stanjem u kojem su pacijenti. Stopa smrtnosti zbog gljivičnih infekcija nije se znatno promijenila u posljednjih nekoliko godina. Stoga u okruženju kritično bolesnih pacijenata bavljenje gljivičnim infekcijama još uvijek je izazovno i postoji potreba za daljnjim istraživanjem i razvojem novih pristupa. Prethodna otkrića antifungalnih lijekova su bila uspješna u liječenju, ali su stvorila prostor za pojavu novih gljivičnih vrsta, a široko korištenje antibiotika i antifungalnih lijekova dovelo je do sve veće rezistencije. Još uvijek postoje poteškoće u ranom otkrivanju gljivičnih infekcija iako znamo da je upravo to presudno za uspjeh liječenja. Uz današnju pojavu novih vrsta gljiva i porast rezistencije traže se novi pristupi dijagnostici i liječenju gljivičnim infekcijama u jedinici intenzivnog liječenja (JIL). ----- METODE: PubMed i Google znalac upotrijebljeni su za pronalaženje relevantnog materijala. Izrazi za pretraživanje su uključivali, ali nisu bili ograničeni na: invazivnu kandidijazu, JIL, liječenje, aspergiloza, čimbenike rizika itd. Primarni kriteriji za odabir studija bili su istraživanja temeljena na dokazima i kvaliteta dizajna studija. ----- NALAZI: Postoje pravila za odabir visokorizičnih bolesnika koji bi mogli imati koristi od profilaktičke antifungalne terapije i pokazala su se uspješnima kada se koriste u kombinaciji s kliničkom sumnjom na gljivičnu infekciju, ali još uvijek treba koristiti dobru kliničku praksu. Nove dijagnostičke tehnike (β-D-glukan, PCR) su u razvoju i dovode do bržeg prepoznavanja bolesnika s gljivičnim infekcijama i time bržem početku liječenja; što se pokazalo da pozitivno utječe na stopu preživljavanja. Preporučeno liječenje se promijenilo prema novijim antifungalnim lijekovima, ali također ovisi o dobi pacijenta, imunosnom stanju, lokalizaciji infekcije i izoliranim vrstama gljiva.
Keywords
Invasive fungal infection
Candidemia
Invasive Aspergillosis
ICU
Keywords (croatian)
invazivna gljivična infekcija
kandidemija
invazivna aspergiloza
JIL
Language english URN:NBN urn:nbn:hr:105:691804 Study programme Title: Medicine (in English language) Type of resource Text File origin Born digital Access conditions Open access Terms of use Created on 2018-04-26 09:38:36
