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Epidemiol."],"published-print":{"date-parts":[[1996,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Over the past decade, the incidence of hospital-acquired bloodstream infections caused by\n                    <jats:italic>Candida<\/jats:italic>\n                    strains has risen, while the implicated species have changed.\n                    <jats:italic>Candida tropicalis, Candida parapsilosis<\/jats:italic>\n                    , and\n                    <jats:italic>Candida glabrata<\/jats:italic>\n                    all have increased in incidence. Data from the Centers for Disease Control and Prevention reveal that, between 1980 and 1990,\n                    <jats:italic>Candida<\/jats:italic>\n                    emerged as the sixth most common nosocomial pathogen (7.2.%) and was the fourth most common pathogen in nosocomial bloodstream infections, surpassed only by coagulase-negative staphylococci,\n                    <jats:italic>Staphylococcus aureus<\/jats:italic>\n                    , and enterococci. The incidence of candidemia is dramatically higher in high-risk critical-care units: 25% of cases occur in surgical intensive-care units (ICUs) versus 25% in bone marrow transplantation units, 20% in medical ICUs, 20% in general medical wards, and 10% in oncology-hematology units. Burns and gastrointestinal surgery predispose to nosocomial candidemia. Independent risk factors include prior therapy with multiple antibiotics, isolation of\n                    <jats:italic>Candida<\/jats:italic>\n                    from sites other than blood, and prior hemodialysis. Crude mortality exceeds 55% and is associated with older age and concomitant renal failure, hepatic failure, acute respiratory diseases, or postoperative shock. In addition to extreme vigilance for early recognition of\n                    <jats:italic>Candida<\/jats:italic>\n                    sepsis in critically ill surgical patients, the high risk for candidemia probably necessitates fungal surveillance cultures and initiation of preemptive antifungal therapy in high-risk surgical patients.\n                  <\/jats:p>","DOI":"10.1086\/647373","type":"journal-article","created":{"date-parts":[[2009,9,9]],"date-time":"2009-09-09T16:30:44Z","timestamp":1252513844000},"page":"558-564","source":"Crossref","is-referenced-by-count":23,"title":["Epidemiology, Diagnosis, and Therapy of Fungal Infections in Surgery"],"prefix":"10.1017","volume":"17","author":[{"given":"Helen","family":"Giamarellou","sequence":"first","affiliation":[{"name":"Athens University School of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anastasia","family":"Antoniadou","sequence":"additional","affiliation":[{"name":"Athens University School 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