Evidence-based clinical standard for the diagnosis and treatment of candidemia in critically ill patients in the intensive care unit

Oct 5, 2026

Uploaded by Đào

Candidemia is identified as the predominant invasive Candida infection and a leading severe fungal cause in critically ill patients admitted to intensive care units (ICU). Latin American studies show higher incidence and mortality compared with North America and Europe, supporting the need for region-specific guidance. An evidence-based clinical standard, built through expert consensus, provides recommendations and diagnostic/therapeutic algorithms for correctly diagnosing and managing candidemia in critically ill ICU patients.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages9

Reading Time23 min

AccessFree to download

Introduction

Background on candidemia in the ICU

Regional epidemiology and outcomes

Rationale for evidence-based clinical standards

Diagnostic considerations

Limitations of reporting and available frequency estimates

Clinical standard framework

Expert consensus and algorithm-based guidance

Braz J Infect Dis. 29 (2025) 104495 Contents lists available at ScienceDirect Brazilian Journal of Infectious Diseases journal [homepage:](homepage: www.elsevier.com/locate/bjid)[ www.elsevier.com/locate/bjid](homepage: www.elsevier.com/locate/bjid) | Original Article
Evidence-based clinical standard for the diagnosis and treatment of candidemia in critically ill patients in the intensive care unit
Jorge Alberto Cort´es a,b,* , Martha Carolina Valderrama-Riosa,b,
Paula M. Peçanha-Pietrobom c , Moacyr Silva Júniord , C´andida Diaz-Brocheroe , Rafael Ricardo Robles-Torres a , Carmelo Jos´e Espinosa-Almanzaa ,
Laura Cristina Nocua-B´aeza , Marcio Nuccif, Carlos Arturo ´Alvarez-Moreno a,g , Flavio Queiroz-Telles h , Ricardo Rabagliatii , Rita Rojas-Fermínj ,
Jorge L. Finquelievichk, Fernando Rieral,m , Patricia Cornejo-Ju´arez n , Dora E. Corzo-Le´ono , Luis E. Cu´ellarp, Jeannete Zurita q,r ,
Augusto Raúl Hern´andez s , Arnaldo Lopes Colombo c,t
a Universidad Nacional de Colombia, Facultad de Medicina, Departamento de Medicina Interna, Bogota´, Colombia b Hospital Universitario Nacional de Colombia, Unidad de Infectología, Bogot´a, Colombia
c Universidade Federal de S˜ao Paulo, Escola Paulista de Medicina, Departamento de Medicina, Divis˜ao de Enfermidades Infecciosas, S˜ao Paulo, SP, Brasil d Hospital Israelita Albert Einstein, S˜ao Paulo, SP, Brasil
e Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Departamento de Medicina Interna, Bogot´a, Colombia
f Universidade Federal do Rio de Janeiro, Hospital Universit´ario, Departament of Internal Medicine, Rio de Janeiro, RJ, Brazil; Grupo Oncoclínicas, Brazil g Clínica Universitaria Colombia, Clínica Colsanitas Grupo Keralty, Bogot´a, Colombia
h Universidade Federal de Parana´, Hospital de Clínicas, Departamento de Saúde Pública, Curitiba, PR, Brasil i Pontificia Universidad Cat´olica de Chile, Escuela de Medicina, Department of Adult Infectious Diseases, Santiago, Chile j Hospital General Plaza de la Salud, Santo Domingo, República Dominicana
k Universidad de Buenos Aires, Facultad de Medicina, Centro de Micología, Buenos Aires, Argentina
l Divisi´on de Enfermedades Infecciosas, Sanatorio Allende C´ordoba, C´ordoba, Argentina m Universidad Nacional de C´ordoba, Enfermedades Infecciosas, C´ordoba, Argentina n Instituto Nacional de Cancerología, Departamento de Infectología, Ciudad de M´exico, Mexico
o Universidad de Exeter, Centro de Micología M´edica del Medical Research Council, Exeter, Reino Unidop Instituto Nacional de Enfermedades Neopl´asicas, Lima, Perú
q Pontificia Universidad Cat´olica del Ecuador, Facultad de Medicina, Quito, Ecuador r Zurita & Zurita Laboratorios, Unidad de Investigaciones en Biomedicina, Quito, Ecuador s Hospital Pacifica Salud, Departamento de Medicina Crítica, Ciudad de Panam´a, Panam´at Antimicrobial Resistance Institute of S˜ao Paulo (ARIES), S˜ao Paulo, SP, Brasil | | | | | --- | --- | --- | --- | | A R T I C L E I N F O | | A B S T R A C T | | | Keywords: Candidemia Critical illness Intensive care units Antifungals
Latin America | | Candidemia is the predominant form of invasive candidiasis and the most frequently occurring serious fungal infection in critically ill patients in Intensive Care Units (ICU). Studies carried out in Latin America reveal a higher incidence of candidemia and higher mortality rates when compared to North America or Europe. This highlights the need to develop guidelines for correctly diagnosing and treating candidemia in critically ill patients in the ICU. These guidelines are part of the efforts to implement antifungal optimization programs in the region to obtain better clinical outcomes and promote rational antifungal use. This evidence-based clinical standard, established through expert consensus for the Latin American context, contains recommendations and algorithms for diagnosing and treating candidemia in critically ill ICU patients. |

FAQs

Why is a region-specific candidemia guideline needed for critically ill ICU patients?

Higher candidemia incidence and mortality rates in Latin America compared with North America or Europe highlight the need for guidelines tailored to this context.

What is the purpose of the evidence-based clinical standard described in the document?

It offers recommendations and diagnostic and treatment algorithms for accurately diagnosing and managing candidemia in critically ill ICU patients, reflecting expert consensus for Latin America.

How can diagnostic reporting practices affect estimates of candidemia frequency?

In many countries, fungal infections are not mandatory reporting, so frequency estimates based on limited population studies may underestimate worldwide disease burden.

Oct 5, 2026

Uploaded by Đào