The Changing Landscape of Invasive Fungal Infections in ICUs: A Need for Risk Stratification to Better Target Antifungal Drugs and the Threat of Resistance

J Fungi (Basel). 2022 Sep 9;8(9):946. doi: 10.3390/jof8090946.

Abstract

The landscape of invasive candidiasis and invasive aspergillosis has changed dramatically in intensive care units over the past two decades. Today, we are faced with new risk factors such as the emergence of resistance, but are also equipped with new therapeutic strategies and diagnostic tools which are changing epidemiological data and diagnostic algorithms. Some common points need to be addressed: (i) the best way to use microbiological tools and to integrate their results in decisional algorithms; (ii) the need to find the optimum balance between under-diagnosis and overtreatment; (iii) and the need to decipher pathophysiology. In this short review, we will try to illustrate these points.

Keywords: antifungal; candidemia; diagnosis algorithm; invasive aspergillosis; invasive candidiasis; risk factors.

Publication types

  • Review

Grants and funding

This work was supported by internal funding “Fonds d’aide à l’émergence et à l’excellence du CHRU de Lille-Bonus H 2022”.