Javea consensus guidelines for the treatment of Candida peritonitis and other intra-abdominal fungal infections in non-neutropenic critically ill adult patients

Data de publicació: 31/07/2017

Autors de IIS La Fe

Javier Pemán García

Autor
Gerardo Aguilar Aguilar

Autor
Elisa Valia Cotanda

Autor
Miguel Salavert Lletí

Autor
Rosa Zaragozá Colom

Autor

Autors aliens a IIS La Fe

Navarro, D
Jávea Intra-Abdominal Fungal Infection Group

Grups d'Investigació

Infección Grave

Investigador Principal

María Ángeles Tormo Mas

Abstract

Background: Although the management of the invasive candidiasis has improved in the last decade, controversial issues yet remain, especially in the diagnostic and therapeutic approaches to Candida peritonitis and other forms of intra-abdominal fungal infections. Aims: We sought to identify core clinical knowledge about intra-abdominal fungal infections and to achieve high-agreement recommendations required to care for critically ill adult patients with Candida peritonitis and other forms of intra-abdominal fungal infection. Methods: A biregional Spanish survey, to elucidate the consensus about the already mentioned fungal infections by means of the Delphi technique, was conducted anonymously by e-mail with 29 multidisciplinary experts in invasive fungal infections from 14 hospitals in the Valencia and Murcia communities during 2014. Respondents included intensivists, anesthesiologists, microbiologists, pharmacologists, and infectious disease specialists, who answered 31 questions prepared by a coordination group after a strict review of the literature from the 5 previous years. The educational objectives spanned 6 categories: epidemiology, microbiological diagnosis, clinical diagnosis, antifungal treatment, de-escalation therapy, and special situations. The agreement required among the panelists for each item to be selected had to be higher than 70%. After extracting the recommendations from the selected items, a meeting at which the experts were asked to validate the previously selected recommendations in a second round of scoring took place. Results: After the second round, 36 recommendations were validated according to the following distribution: epidemiology (5), microbiological diagnosis (4), clinical diagnosis (4), antifungal treatment (3), de-escalation therapy (4), and special situations (16). Conclusions: Treatment of Candida peritonitis and other forms of intra-abdominal fungal infections in ICU patients requires a broad range of knowledge application and skills that our recommendations address. Based on the DELPHI methodology, these recommendations might help to optimize the therapeutic management of these patients in special situations and in various scenarios to improve their outcome. (C) 2017 Asociacion Espanola de Micologia. Published by Elsevier Espana, S.L.U. All rights reserved.

Dades de la publicació

ISSN/ISSNe:: 1130-1406, 2173-9188
Tipus:: Article
Pàgines:: 130-142
DOI:: 10.1016/j.riam.2016.12.001
PubMed:: 28579084
Factor d'Impacte:: 0,432 SCImago ℠
Quartil:: Q3 SCImago ℠

Documents

No hi ha documents

Mètriques

Filiacions

Peman, J:: Servicio de Microbiología, Hospital Universitario y Politécnico La Fe, Valencia, Spain

Hosp Univ & Politecn La Fe, Serv Microbiol, Valencia, Spain
Aguilar, G:: Servicio de Microbiología, Hospital Universitario y Politécnico La Fe, Valencia, Spain

Hosp Univ & Politecn La Fe, Serv Microbiol, Valencia, Spain
Valia, JC:: Servicio de Microbiología, Hospital Universitario y Politécnico La Fe, Valencia, Spain

Hosp Univ & Politecn La Fe, Serv Microbiol, Valencia, Spain
Salavert, M:: Servicio de Microbiología, Hospital Universitario y Politécnico La Fe, Valencia, Spain

Hosp Univ & Politecn La Fe, Serv Microbiol, Valencia, Spain
Navarro, D:: Servicio de Microbiología, Hospital Universitario y Politécnico La Fe, Valencia, Spain

Hosp Univ & Politecn La Fe, Serv Microbiol, Valencia, Spain
Zaragoza, R:: Servicio de Microbiología, Hospital Universitario y Politécnico La Fe, Valencia, Spain

Hosp Univ & Politecn La Fe, Serv Microbiol, Valencia, Spain
Jávea Intra-Abdominal Fungal Infection Group:: Servicio de Microbiología, Hospital Universitario y Politécnico La Fe, Valencia, Spain