Publication: Impacto en las infecciones fúngicas invasivas de un hospital general de un programa de intervención diagnóstica, terapéutica y preventiva
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2019-05-29
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Universidad Complutense de Madrid
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Abstract
En los últimos años, las infección fúngicas invasoras (IFI) han adquirido un protagonismo especial en los hospitales modernos, debido fundamentalmente a su elevada tasa de morbilidad y mortalidad y a su elevado consumo de recursos tanto para su prevención como para su manejo. Además, estas infecciones constituyen un reto concreto y continuo para los clínicos ya que existen muchas incertidumbres que afectan aspectos diagnósticos, terapéuticos y preventivos. OBEJETIVOS Con esta tesis pretendemos aclarar una serie de dudas relacionadas con el diagnóstico y manejo de las IFI, que todavía no han sido resueltas por la comunidad científica. En concreto nos hemos planteado los siguientes objetivos: Primer objetivo: Describir la incidencia, factores clínicos predisponentes y la evolución de los pacientes con candidemia complicada. Evaluar si en comparación con los hemocultivos tradicionales y el (13)-beta-D-glucano, la determinación seriada de T2MR es capaz de discriminar entre candidemia complicada y no complicada. Segundo objetivo: Evaluar la utilidad clínica de los biomarcadores de candidiasis invasiva y del T2MR usados prospectivamente en pacientes con sospecha de candidiasis invasiva que reciben tratamiento empírico para la retirada precoz de los tratamientos antifúngicos innecesarios...
In recent years, invasive fungal infections (IFI) are regarded as a significant health problem, mainly due to their high morbidity, mortality and high resources utilization, both for prevention and monitoring. In addition, these infections represent a continuous challenge for clinicians since there are many unmeet needs that include diagnostic, therapeutic and preventive aspects. OBJECTIVES: First objective: To assess the usefulness of follow-up T2MR in comparison with blood cultures and the (1-->3)-beta-D-glucan assay for the early differentiation of patients with complicated or uncomplicated Candida BSI Second objective: To assess the potential role of T2Candida MR (T2MR) and serological biomarkers [Candida albicans germ tube antibodies (CAGTA) or (1-->3)-beta-D-glucano (BDG)], alone or in combination with standard cultures, for identifying patients with suspected invasive candidiasis, who may benefit from maintaning antifungal therapy. Third objective: To assess the clinical impact of a comprehensive care bundle for the management of candidemia...
In recent years, invasive fungal infections (IFI) are regarded as a significant health problem, mainly due to their high morbidity, mortality and high resources utilization, both for prevention and monitoring. In addition, these infections represent a continuous challenge for clinicians since there are many unmeet needs that include diagnostic, therapeutic and preventive aspects. OBJECTIVES: First objective: To assess the usefulness of follow-up T2MR in comparison with blood cultures and the (1-->3)-beta-D-glucan assay for the early differentiation of patients with complicated or uncomplicated Candida BSI Second objective: To assess the potential role of T2Candida MR (T2MR) and serological biomarkers [Candida albicans germ tube antibodies (CAGTA) or (1-->3)-beta-D-glucano (BDG)], alone or in combination with standard cultures, for identifying patients with suspected invasive candidiasis, who may benefit from maintaning antifungal therapy. Third objective: To assess the clinical impact of a comprehensive care bundle for the management of candidemia...
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Tesis de la Universidad Complutense de Madrid, Facultad de Medicina, leída el 20-12-2018