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  2. Vol 56, No 2 (2024)
  3. Rozaliyani

Expert Panel Recommendations on the Clinical Practice Guidelines for the Diagnosis and Management of Invasive Candidiasis in Indonesia

Anna Rozaliyani, Erni Juwita Nelwan, Mardiastuti Wahid, Dita Aditianingsih, Mulya Rahma Karyanti, Siti Pratiekauri, Adityo Susilo, Fathiyah Isbaniah, Heidy Agustin, Yulia Rosa Saharman, Robiatul Adawiyah, Findra Setianingrum, Vera Irawany, Rudyanto Sedono, Debbie Latupeirissa, Nina Dwi Putri, Winda Sofvina, Mulyati Tugiran

Abstract


Invasive candidiasis (IC) ranks among the primary causes of deadly fungal infections. The frequency of IC rises alongside increasing number of patients with altered immune systems, critically ill, chronic diseases, and various medical procedures. The disease causes high morbidity and mortality, as well as prolonged stay and increases hospital costs. The diagnosis and management of IC in Indonesia is still a challenge. Laboratory facilities in identifying pathogenic fungi and susceptibility tests to antifungals are still limited. Clinical awareness and financial support from health policymakers are also insufficient. Early diagnosis is essential for proper treatment to reduce morbidity and mortality rates. Initiated by the Indonesian Pulmonary Mycoses Centre (IPMC), several expert representatives from six medical professional organizations in Indonesia have agreed to set up a meeting series to prepare a joint draft on the diagnosis and management of IC. The expert panel aimed to achieve a consensus on the clinical practice guidelines for diagnosing and treating IC in Indonesia.

Keywords


diagnosis; expert panel; invasive candidiasis; management

References


Denning DW. Global incidence and mortality of severe fungal disease. Lancet Infect Dis. 2024;S1473-3099(23)00692-8.

Pappas PG, Lionakis MS, Arendrup MC, Ostrosky-Zeichner L, Kullberg BJ. Invasive candidiasis. Nat Rev Dis Primers. 2018;4:1–20.

Koehler P, Stecher M, Cornely OA, et al. Morbidity and mortality of candidaemia in Europe: an epidemiologic. Clin Microbiol Infect. 2019;25:1200–12.

WHO. WHO fungal priority pathogens list to guide research, development and public health action. Geneva: World Health Organization; 2022.

Wahyuningsih R, Adawiyah R, Sjam R, et al. Serious fungal disease incidence and prevalence in Indonesia. Mycoses. 2021;64:1203–12.

De Pauw B, Walsh TJ, Donnelly JP, et al. Revised definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) Consensus Group. Clin Infect Dis. 2008;46:1813–21.

Donnelly PJ, Chen SC, Kauffman CA, et al. Revision and update of the consensus definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer and the Mycoses Study Group Education and Research Consortium. Clin Infect Dis. 2020;71:1367–76.

Bassetti M, Azoulay E, Kullberg BJ, et al. EORTC/MSGERC Definitions of invasive fungal diseases: summary of activities of the Intensive Care Unit working group. Clin Infect Dis. 2021;72:S121–7.

Pappas PG, Kauffman CA, Andes DR, et al. Executive summary: clinical practice guideline for the management of candidiasis: 2016 Update by the Infectious Diseases Society of America. Clin Infect Dis. 2015;62:409–17.

Chang CC, Blyth CC, Chen SCA, et al. Introduction to the updated Australasian consensus guidelines for the management of invasive fungal disease and use of antifungal agents in the haematology/oncology setting, 2021. Intern Med J. 2021;51:3–17.

Cornely OA, Bassetti M, Calandra T, et al. ESCMID* guideline for the diagnosis and management of Candida diseases 2012: non-neutropenic adult patients. Clin Microbiol Infect. 2012;18:19–37.

Martin-Loeches I, Antonelli M, Cuenca-Estrella M, et al. ESICM/ESCMID task force on practical management of invasive candidiasis in critically ill patients. Intensive Care Med. 2019; 45:789–805.

Tissot F, Agrawal S, Pagano L, et al. ECIL-6 guidelines for the treatment of invasive candidiasis, aspergillosis and mucormycosis in leukemia and hematopoietic stem cell transplant patients. Haematologica. 2017; 102:433–44.

Groll AH, Pana D, Lanternier F, et al. 8th European Conference on Infections in Leukaemia: 2020 guidelines for the diagnosis, prevention, and treatment of invasive fungal diseases in paediatric patients with cancer or post-haematopoietic cell transplantation. Lancet Oncol. 2021;22: e254–69.

Piggott T, Morgan RL, Cuello-Garcia CA, et al. Grading of recommendations assessment, development, and evaluations (GRADE) notes: extremely serious, GRADE’s terminology for rating down by three levels. J Clin Epidemiol. 2020;120:116–20.

Chapman B, Slavin M, Marriott D, et al. Changing epidemiology of candidaemia in Australia. J Antimicrob Chemother 2017;72:1103-8.

Adam K manuel, Osthoff M, Lamoth F, et al. Trends of the epidemiology of candidemia in Switzerland : A 15-Year FUNGINOS Survey. Open Forum Infect Dis. 2021;8:1–9.

Kim JH, Suh JW, Kim MJ. Epidemiological trends of candidemia and the impact of adherence to the candidemia guideline: Six-year single-center experience. J Fungi. 2021;7:1-7.

Walsh TJ, Katragkou A, Chen T, Salvatore CM, Roilides E. Invasive candidiasis in infants and children: Recent advances in epidemiology, diagnosis, and treatment. J Fungi. 2019;5:1-8.

Benedict K, Roy M, Kabbani S, et al. Neonatal and pediatric candidemia: results from population-based active laboratory surveillance in four US locations, 2009-2015. J Pediatric Infect Dis Soc. 2018;7:e78-85.

Lausch KR, Schultz Dungu KH, Callesen MT, et al. Pediatric candidemia epidemiology and morbidities: a nationwide cohort. Pediatric Infect Dis J. 2019;38: 464–9.

Mursinah M, Ibrahim F, Wahid M. Candida profile causes candidemia and pattern of sensitivity to antifungals in critically ill patients at Cipto Mangunkusuno Hospital. Indones J Biotech Med. 2016;5:105-11.

Kalista KF, Chen LK, Wahyuningsih R, Rumende CM. Karakteristik klinis dan prevalensi pasien kandidiasis invasif di Rumah Sakit Cipto Mangunkusumo. Jurnal Penyakit Dalam Indonesia. 2017;4:56-60.

Maulana HR, Sumardi U, Koesoemadinata RC. Prevalensi kandidiasis invasif di unit perawatan intensif Rumah Sakit Hasan Sadikin Bandung. Jurnal Penyakit Dalam Indonesia. 2019;6:8-10.

Rinawati W, Kumalawati J, Bardosono S, Immanuel S, Sukartini N, Indrasari ND. Invasive candidiasis among high prevalence neurological patients. J Infect Dev Ctries. 2022;16:871–80.

Indrawan DK, Pudjiadi AH, Latief AL. Insidens kandidemia di Paediatric Intensive Care Unit Rumah Sakit Dr. Cipto Mangunkusumo. Sari Pediatri. 2017;18:182-5.

Rozaliyani A. Kandidemia pada neonatus dan profil resistansi Candida spp. terhadap derivat azol (thesis). Jakarta: Universitas Indonesia; 2004.

Quindós G. Epidemiology of candidaemia and invasive candidiasis. A changing face. Rev Iberoam Micol. 2014;31:42–8.

Pfaller MA, Diekema DJ, Turnidge JD, Castanheira M, Jones RN. Twenty years of the SENTRY antifungal surveillance program: results for Candida species from 1997 – 2016. Open Forum Infect Dis. 2019; 6: S79–94.

Hachem R, Hanna H, Kontoyiannis D, Jiang Y, Raad I. The changing epidemiology of invasive candidiasis: Candida glabrata and Candida krusei as the leading causes of candidemia in hematologic malignancy. Cancer. 2008;112:2493-9.

Wahyuningsih R, Rozaliyani A, Jannah S, Amir I, Prihartono J. Kandidemia pada neonatus yang mengalami kegagalan terapi antibiotik. Majalah Kedokt Indones. 2008;58:110–5.

Tan TY, Tan AL, Tee NWS, Ng LSY, Chee CWJ. The increased role of non-albicans species in candidaemia: Results from a 3-year surveillance study. Mycoses. 2010;53:515–21.

Soriano A, Honore PM, Puerta-Alcalde P, et al. Invasive candidiasis: current clinical challenges and unmet needs in adult populations. J Antimicrob Chemother. 2023;78:1569-85.

Thomas-Rüddel DO, Schlattmann P, Pletz M, Kurzai O, Bloos F. Risk factors for invasive Candida infection in critically ill patients: a systematic review and meta-analysis. Chest. 2022;161:345–55.

Logan C, Martin-Loeches I, Bicanic T. Invasive candidiasis in critical care: challenges and future directions. Intensive Care Med. 2020;46:2001–14.

Riera FO, Caeiro JP, Angiolini SC, et al. Invasive candidiasis: update and current challenges in the management of this mycosis in South America. Antibiotics. 2022;11:1–16.

Alves J, Palma P, Azevedo D, et al. Candidemia in the patient with malignancy. Hosp Pract. 2018;46:246–52.

Berkow EL, Lockhart SR. Fluconazole resistance in Candida species: a current perspective. Infect Drug Resist. 2017;10:237–45.

McCarty TP, White CM, Pappas PG. Candidemia and invasive candidiasis. Infect Dis Clin North Am. 2021; 35:389–413.

Krcmery V, Barnes AJ. Non-albicans Candida spp. causing fungaemia: pathogenicity and antifungal resistance. J Hosp Infect. 2002;50:243–60.

Nishida R, Eriguchi Y, Miyake N, et al. Breakthrough candidemia with hematological disease: results from a single-center retrospective study in Japan, 2009-2020. Med Mycol. 2023;61:1-8.

Whaley SG, Berkow EL, Rybak JM, Nishimoto AT, Barker KS, Rogers PD. Azole antifungal resistance in Candida albicans and emerging non-albicans Candida species. Front Microbiol. 2016;7:2173-6.

Keighley C, Cooley L, Morris AJ, et al. Consensus guidelines for the diagnosis and management of invasive candidiasis in haematology, oncology and intensive care settings, 2021. Intern Med J. 2021;51: 89–117.

Worth LJ, Harrison SJ, Dickinson M, van Diemen A, Breen J, Harper S, et al. Candida auris in an Australian health care facility: importance of screening high risk patients. Med J Australia. 2020;212:510-15.

Drummond RA, Desai J V, Ricotta EE, et al. Article Long-term antibiotic exposure promotes mortality after systemic fungal infection by driving lymphocyte dysfunction and systemic escape of commensal bacteria: long-term antibiotic exposure promotes mortality after systemic fungal infection. Cell Host Microbe. 2022;30:1020-33.

Yapar N, Pullukcu H, Avkan-Oguz V, et al. Evaluation of species distribution and risk factors of candidemia: A multicenter case-control study. Med Mycol. 2010; 49:26–31.

Keighley C, Chen SCA, Marriott D, et al. Candidaemia and a risk predictive model for overall mortality: a prospective multicentre study. BMC Infect Dis. 2019; 19: 1–10.

Lass-Flörl C, Kanj SS, Govender NP, Thompson GR, Ostrosky- Zeichner L, Govrins MA. Invasive candidiasis. Nat Rev Dis Primers. 2024;10:1–18.

Tong Y, Tang J. Candida albicans infection and intestinal immunity. Microbiol Res. 2017;198:27–35.

Kumamoto CA, Gresnigt MS, Hube B. The gut, the bad and the harmless: Candida albicans as a commensal and opportunistic pathogen in the intestine. Curr Opin Microbiol. 2020;56:7–15.

Martins N, Ferreira ICFR, Barros L, Silva S, Henriques M. Candidiasis: Predisposing factors, prevention, diagnosis and alternative treatment. Mycopathologia. 2014;177:223–40.

Clancy CJ, Nguyen MH. Diagnosing invasive candidiasis. J Clin Microbiol. 2018; 56: 1–9.

Barantsevich N, Barantsevich E. Diagnosis and treatment of invasive candidiasis. Antibiotics. 2022; 11:718-15.

Kullberg BJ, Arendrup MC. Invasive Candidiasis. In: Campion EW, editor. New Eng J Med. 2015;373: 1445–56.

Kotey FC, Dayie NT, Tetteh-Uarcoo PB, Donkor ES. Candida bloodstream infections: changes in epidemiology and increase in drug resistance. Infect Dis. 2021;14:1-5.

Pitarch A, Nombela C, Gil C. Diagnosis of invasive candidiasis: from gold standard methods to promising leading-edge technologies. Curr Top Med Chem. 2018; 18:1375–92.

Sabino R, Wiederhold N. Diagnosis from tissue: histology and identification. J Fungi. 2022;8:1–8.

Hage CA, Carmona EM, Epelbaum O, et al. Microbiological laboratory testing in the diagnosis of fungal infections in pulmonary and critical care practice: An official American Thoracic Society clinical practice guideline. Am J Respir Crit Care Med. 2019;200:535–50.

Miller JM, Binnicker MJ, Campbell S, et al. A Guide to utilization of the microbiology laboratory for diagnosis of infectious diseases: 2018 Update by the Infectious Diseases Society of America and the American Society for Microbiology. Clin Infect Dis. 2018;67:e1–94.

Juneja D, Jain R, Singh O, Borah AK. Candida Score: a Predictor of mortality in patients with candidemia. J Assoc Physicians India. 2022;70:11–2.

Mursinah, Ibrahim F, Wahid MH. Risk factors and scoring systems for patients with candidemia at a tertiary hospital in Jakarta, Indonesia. Acta Med Indones. 2016;48:193–9.

Ratridewi I, Juwita N, Putera MA, Nugroho S. Peran skor Candida sebagai metode diagnostik kandidiasis invasif terhadap neutropenia berat pada anak dengan keganasan. Sari Pediatri. 2021;22:351-5.

Mikulska M, Giacobbe DR, Furfaro E, et al. Lower sensitivity of serum (1,3)-β-D-glucan for the diagnosis of candidaemia due to Candida parapsilosis. Clin Microbiol Infect. 2016;22:646.e5-8.

Uneno Y, Imura H, Makuuchi Y, Tochitani K, Watanabe N. Pre-emptive antifungal therapy versus empirical antifungal therapy for febrile neutropenia in people with cancer. Cochrane Database Syst Rev. 2022;11:1-10.

Tortorano AM, Prigitano A, Morroni G, Brescini L, Barchiesi F. Candidemia: evolution of drug resistance and novel therapeutic approaches. Infect Drug Resist. 2021;14:5543–53.


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