Does Fungal Ventilator-associated Pneumonia Exist in ICU Patients Without Major Immunosuppression?
Colonization of the lower respiratory tract by Candida spp. affects 18–56% of intubated patients and is associated with an increased risk of bacterial VAP, most notably caused by P. aeruginosa or other MDR pathogens, and possibly a poorer outcome.[74–77] However, available data do not support a direct role of Candida spp. as a VAP-causative pathogen.[78,79]Aspergillus spp. (mainly Aspergillus fumigatus) may be involved in ~3% of late-onset VAP, and invasive pulmonary aspergillosis has been proven in 15% of critically ill patients with one or more Aspergillus-positive tracheal aspirate cultures. A clinical algorithm was recently proposed to assess the clinical relevance of these cultures and ease the decision to start or not a specific therapy.
Curr Opin Pulm Med. 2013;19(3):216-228. © 2013 Lippincott Williams & Wilkins