Incidence of candidaemia and antifungal sensitivity in critically ill patients
Notice bibliographique
Résumé
Candidaemia is increasing all over the world in recent years mainly in critically ill patients. Invasive candidiasis is becoming an important nosocomial infection. Bloodstream infections (BSIs) caused by Candida spp are a major cause of morbidity and mortality in immune-compromised hosts. The prevalence of fungal infections has progressively increased, because the population of immune-deficient subjects has expanded due to advances in supportive therapy as well as the number of elderly people in our society. In these patients, the most common infections caused by Candida spp are invasive candidiasis (IC) and candidaemia, \nThe incidence of IC was remarkably consistent in US increasing from 1979 to 2001 of about 300% in parallel with the increase of bacterial infections. The mortality rate resulted to be higher in candidaemia than in bacterial infection. C. albicans was the most frequently isolated fungal species with 43.6% of occurrence followed by C. glabrata ( 26.7%) , C.parapsilosis (16%) , C. tropicalis (10%) ,C. krusei (2%) etc. The distribution of Candida spp is quite different in US and in Europe. In Europe and in Canada, blood-stream infections by Candida are lower than that reported from United States where C. glabrata is the most frequent species among non-albicans Candida. \n The variation in the frequency of C. glabrata may depend on exposure to azoles especially fluconazole used in prophylaxis in high risk critically ill patients. In any case, a shift to non-albicans species and a growing resistance to the common antifungal drugs have been noticed over the last years. \nCandida spp is part of the normal flora of human skin and mucosa gastrointestinal tract: the species are differently distributed in the various districts of the organism. Based on experimental studies and using molecular biology techniques, it has been confirmed that the most frequent origins of candidaemia are the gastrointestinal tract (via bacterial translocation) and the skin (in critically ill patients with venous catheters). \nA model for IC can be explained through the insult on the epithelial cells of gastro-intestinal tract and the use of antibiotics affecting the normal intestinal flora. This may select Candida species promoting the infection , the following translocation from gastro-intestinal tract to bloodstream finally leading to the disseminated disease and eventual colonization of CVC. \nThe connection between intensive care unit (ICU) and fungal infections has been demonstrated in several studies (......). In case of critically ill patients admitted in an ICU, a lot of risk factors are involved such as underlying diseases, presence of venous catheters, parenteral nutrition, use of antibiotics , acute pancreatitis, abdominal surgery etc.. \nCandida colonization, defined as growth of yeast from non-sterile sites, is usually the first stage for most cases of invasive candidiasis in critically ill patients and it has been considered as an early marker of deep infection. Then previous colonization by Candida in non-sterile sites has been identified as a risk factor for invasive infection. In fact, 60-80% of patients with candidaemia were previously colonized by the same species.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».