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Chapter 19 : Non- Infections

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Non- Infections, Page 1 of 2

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Abstract:

There has been an increase in both the proportion as well as prevalence of non-albicans species, including patients who experience breakthrough infection with non- strains. was the least common cause of bloodstream infection (BSI) in Latin America (7.5%) and the most common in Canada (20.1%) and the United States (18.3%). Understandably, local institutional antifungal pressure affects the local epidemiology of candidiasis as well as affecting antimicrobial resistance. was more frequently seen in patients with hematologic malignancies in one study. While some centers have reported an increased mortality associated with non- species compared to , there is no consistent pattern. In discussing mortality, it should be emphasized that multiple host factors and treatment variables other than the virulence of the yeast strain involved can contribute to and influence mortality. Testing was always indicated for persistent and recurrent candidemia and for unique clinical scenarios, e.g., , particularly with the presence of non- species. The explanation for this phenomenon is still incomplete but includes small numbers of patients with non- species infections and the impact of host factors, e.g., inconsistent catheter removal, abscess drainage, etc., diluting the importance of species differences in drug susceptibility. Individual cases have also been reported in which the reduced susceptibility or resistance of individual isolates, especially those of non- species, do influence clinical outcome and validate the importance of in vitro susceptibility tests.

Citation: Sobel J, Revankar S. 2008. Non- Infections, p 393-411. In Scheld W, Hammer S, Hughes J (ed), Emerging Infections 8. ASM Press, Washington, DC. doi: 10.1128/9781555815592.ch19

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Incidence of BSIs in hospital ICUs in the United States. Reprinted from reference with permission.

Citation: Sobel J, Revankar S. 2008. Non- Infections, p 393-411. In Scheld W, Hammer S, Hughes J (ed), Emerging Infections 8. ASM Press, Washington, DC. doi: 10.1128/9781555815592.ch19
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Tables

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Table 1.

Pathogenic species

Citation: Sobel J, Revankar S. 2008. Non- Infections, p 393-411. In Scheld W, Hammer S, Hughes J (ed), Emerging Infections 8. ASM Press, Washington, DC. doi: 10.1128/9781555815592.ch19
Generic image for table
Table 2.

Factors associated with emergence of non- infections

Citation: Sobel J, Revankar S. 2008. Non- Infections, p 393-411. In Scheld W, Hammer S, Hughes J (ed), Emerging Infections 8. ASM Press, Washington, DC. doi: 10.1128/9781555815592.ch19
Generic image for table
Table 3.

Major pathogenic species and their characteristics

Citation: Sobel J, Revankar S. 2008. Non- Infections, p 393-411. In Scheld W, Hammer S, Hughes J (ed), Emerging Infections 8. ASM Press, Washington, DC. doi: 10.1128/9781555815592.ch19
Generic image for table
Table 4.

General patterns of susceptibility of species

Citation: Sobel J, Revankar S. 2008. Non- Infections, p 393-411. In Scheld W, Hammer S, Hughes J (ed), Emerging Infections 8. ASM Press, Washington, DC. doi: 10.1128/9781555815592.ch19
Generic image for table
Table 5.

Treatment guidelines for non- infections

Citation: Sobel J, Revankar S. 2008. Non- Infections, p 393-411. In Scheld W, Hammer S, Hughes J (ed), Emerging Infections 8. ASM Press, Washington, DC. doi: 10.1128/9781555815592.ch19

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