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      Evidence-based clinical standard for the diagnosis and treatment of candidemia in critically ill patients in the intensive care unit

      research-article
      a , b , * , a , b , c , d , e , a , a , a , f , a , g , h , i , j , k , l , m , n , o , p , q , r , s , c , t
      The Brazilian Journal of Infectious Diseases
      Elsevier
      Candidemia, Critical illness, Intensive care units, Antifungals, Latin America

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          Abstract

          Candidemia is the predominant form of invasive candidiasis and the most frequently occurring serious fungal infection in critically ill patients in Intensive Care Units (ICU). Studies carried out in Latin America reveal a higher incidence of candidemia and higher mortality rates when compared to North America or Europe. This highlights the need to develop guidelines for correctly diagnosing and treating candidemia in critically ill patients in the ICU. These guidelines are part of the efforts to implement antifungal optimization programs in the region to obtain better clinical outcomes and promote rational antifungal use. This evidence-based clinical standard, established through expert consensus for the Latin American context, contains recommendations and algorithms for diagnosing and treating candidemia in critically ill ICU patients.

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          Most cited references57

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          AGREE II: advancing guideline development, reporting and evaluation in health care.

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            Clinical Practice Guideline for the Management of Candidiasis: 2016 Update by the Infectious Diseases Society of America.

            It is important to realize that guidelines cannot always account for individual variation among patients. They are not intended to supplant physician judgment with respect to particular patients or special clinical situations. IDSA considers adherence to these guidelines to be voluntary, with the ultimate determination regarding their application to be made by the physician in the light of each patient's individual circumstances.
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              Is Open Access

              MALDI-TOF mass spectrometry: an emerging technology for microbial identification and diagnosis

              Currently microorganisms are best identified using 16S rRNA and 18S rRNA gene sequencing. However, in recent years matrix assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) has emerged as a potential tool for microbial identification and diagnosis. During the MALDI-TOF MS process, microbes are identified using either intact cells or cell extracts. The process is rapid, sensitive, and economical in terms of both labor and costs involved. The technology has been readily imbibed by microbiologists who have reported usage of MALDI-TOF MS for a number of purposes like, microbial identification and strain typing, epidemiological studies, detection of biological warfare agents, detection of water- and food-borne pathogens, detection of antibiotic resistance and detection of blood and urinary tract pathogens etc. The limitation of the technology is that identification of new isolates is possible only if the spectral database contains peptide mass fingerprints of the type strains of specific genera/species/subspecies/strains. This review provides an overview of the status and recent applications of mass spectrometry for microbial identification. It also explores the usefulness of this exciting new technology for diagnosis of diseases caused by bacteria, viruses, and fungi.

                Author and article information

                Contributors
                Journal
                Braz J Infect Dis
                Braz J Infect Dis
                The Brazilian Journal of Infectious Diseases
                Elsevier
                1413-8670
                1678-4391
                21 December 2024
                Jan-Feb 2025
                21 December 2024
                : 29
                : 1
                : 104495
                Affiliations
                [a ]Universidad Nacional de Colombia, Facultad de Medicina, Departamento de Medicina Interna, Bogotá, Colombia
                [b ]Hospital Universitario Nacional de Colombia, Unidad de Infectología, Bogotá, Colombia
                [c ]Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Medicina, Divisão de Enfermidades Infecciosas, São Paulo, SP, Brasil
                [d ]Hospital Israelita Albert Einstein, São Paulo, SP, Brasil
                [e ]Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Departamento de Medicina Interna, Bogotá, Colombia
                [f ]Universidade Federal do Rio de Janeiro, Hospital Universitário, Departament of Internal Medicine, Rio de Janeiro, RJ, Brazil; Grupo Oncoclínicas, Brazil
                [g ]Clínica Universitaria Colombia, Clínica Colsanitas Grupo Keralty, Bogotá, Colombia
                [h ]Universidade Federal de Paraná, Hospital de Clínicas, Departamento de Saúde Pública, Curitiba, PR, Brasil
                [i ]Pontificia Universidad Católica de Chile, Escuela de Medicina, Department of Adult Infectious Diseases, Santiago, Chile
                [j ]Hospital General Plaza de la Salud, Santo Domingo, República Dominicana
                [k ]Universidad de Buenos Aires, Facultad de Medicina, Centro de Micología, Buenos Aires, Argentina
                [l ]División de Enfermedades Infecciosas, Sanatorio Allende Córdoba, Córdoba, Argentina
                [m ]Universidad Nacional de Córdoba, Enfermedades Infecciosas, Córdoba, Argentina
                [n ]Instituto Nacional de Cancerología, Departamento de Infectología, Ciudad de México, Mexico
                [o ]Universidad de Exeter, Centro de Micología Médica del Medical Research Council, Exeter, Reino Unido
                [p ]Instituto Nacional de Enfermedades Neoplásicas, Lima, Perú
                [q ]Pontificia Universidad Católica del Ecuador, Facultad de Medicina, Quito, Ecuador
                [r ]Zurita & Zurita Laboratorios, Unidad de Investigaciones en Biomedicina, Quito, Ecuador
                [s ]Hospital Pacifica Salud, Departamento de Medicina Crítica, Ciudad de Panamá, Panamá
                [t ]Antimicrobial Resistance Institute of São Paulo (ARIES), São Paulo, SP, Brasil
                Author notes
                [* ]Corresponding author. jacortesl@ 123456unal.edu.co
                Article
                S1413-8670(24)00777-3 104495
                10.1016/j.bjid.2024.104495
                11846572
                39709887
                1e12d24b-8e33-4bb1-b2c6-339fce0dcceb
                © 2024 Sociedade Brasileira de Infectologia. Published by Elsevier España, S.L.U.

                This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

                History
                : 22 July 2024
                : 26 November 2024
                Categories
                Original Article

                candidemia,critical illness,intensive care units,antifungals,latin america

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