{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T15:24:46Z","timestamp":1790954686986,"version":"4.1.0"},"reference-count":98,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2025,3,27]],"date-time":"2025-03-27T00:00:00Z","timestamp":1743033600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JoF"],"abstract":"<jats:p>Invasive fungal infections in the intensive care unit (ICU) are not uncommon and most cases are caused by Candida species, specifically Candida albicans. However, recently, there has been an increase in non-albicans\u00a0Candida spp. (C. glabrata; C. parapsilosis) causing invasive fungal infections. This has led to an increasing awareness of this infection due to the increase in documented antifungal resistance in many of these Candida species. In addition, manifestations of invasive candidiasis are often non-specific, and the diagnosis remains extremely challenging. Unfortunately, delays in antifungal therapy continue to hamper the morbidity; length of stay; and the mortality of these infections. Although the echinocandins are the drugs of choice in these infections, antifungal resistance among the non-albicans species (C. glabrata; C. krusei; C. auris; C. parapsilosis) is being observed more frequently. This has led to an increase in morbidity and mortality, specifically in critically ill patients. Overall, the diagnosis and management of invasive candidiasis in the ICU remain challenging. It is imperative that the critical care physician keeps this infection at the forefront of their differential diagnosis in order to decrease the mortality rate of these individuals. In this review, we discuss the current epidemiologic trends, diagnosis, and management of invasive candidiasis in the intensive care unit setting.<\/jats:p>","DOI":"10.3390\/jof11040258","type":"journal-article","created":{"date-parts":[[2025,3,28]],"date-time":"2025-03-28T04:11:40Z","timestamp":1743135100000},"page":"258","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Invasive Candidiasis in the Intensive Care Unit: Where Are We Now?"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5774-819X","authenticated-orcid":false,"given":"Jose A.","family":"Vazquez","sequence":"first","affiliation":[{"name":"Division of Infectious Disease, Medical College of Georgia, Augusta University, 1120 15th Street, Augusta, GA 30912, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lissette","family":"Whitaker","sequence":"additional","affiliation":[{"name":"Division of Infectious Disease, Medical College of Georgia, Augusta University, 1120 15th Street, Augusta, GA 30912, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Zubovskaia","sequence":"additional","affiliation":[{"name":"Division of Infectious Disease, Medical College of Georgia, Augusta University, 1120 15th Street, Augusta, GA 30912, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,27]]},"reference":[{"key":"ref_1","unstructured":"(2022, October 25). World Health Organization (WHO) Report. WHO Fungal Priority Pathogens List to Guide Research, Development, and Public Health Action. Available online: https:\/\/www.who.int\/publications\/i\/item\/9789240060241."},{"key":"ref_2","first-page":"e939088","article-title":"Editorial: The World Health Organization (WHO) Fungal Priority Pathogens List in Response to Emerging Fungal Pathogens During the COVID-19 Pandemic","volume":"28","author":"Parnums","year":"2022","journal-title":"Med. Sci. Monit."},{"key":"ref_3","unstructured":"Centers for Disease Control and Prevention (CDC) (2022, March 02). Fungal Diseases and COVID-19, Available online: https:\/\/www.cdc.gov\/fungal\/covid-fungal.html."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1016\/j.idc.2021.03.007","article-title":"Candidemia and Invasive Candidiasis","volume":"35","author":"McCarty","year":"2021","journal-title":"Infect. Dis. Clin. N. Am."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1080\/13693780410001731619","article-title":"Rules for identifying patients at increased risk for candidal infections in the surgical intensive care unit: Approach to developing practical criteria for systematic use in antifungal prophylaxis trials","volume":"43","author":"Paphitou","year":"2005","journal-title":"Med. Mycol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1445","DOI":"10.1056\/NEJMra1315399","article-title":"Invasive Candidiasis","volume":"373","author":"Kullberg","year":"2015","journal-title":"N. Engl. J. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1111\/myc.13054","article-title":"Changes in the relative prevalence of candidaemia due to non-albicans Candida species in adult in-patients: A systematic review, meta-analysis and meta-regression","volume":"63","author":"Giacobbe","year":"2020","journal-title":"Mycoses"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1093\/mmy\/myy054","article-title":"Candida auris: The recent emergence of a multidrug-resistant fungal pathogen","volume":"57","author":"Forsberg","year":"2019","journal-title":"Med. Mycol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1485","DOI":"10.3201\/eid2907.230540","article-title":"Candida auris\u2014Associated Hospitalizations, United States, 2017\u20132022","volume":"29","author":"Benedict","year":"2023","journal-title":"Emerg. Infect. Dis."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"489","DOI":"10.7326\/M22-3469","article-title":"Worsening Spread of Candida auris in the United States, 2019 to 2021","volume":"176","author":"Lyman","year":"2023","journal-title":"Ann. Intern. Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1093\/infdis\/168.1.195","article-title":"Nosocomial acquisition of Candida albicans: An epidemiologic study","volume":"168","author":"Vazquez","year":"1993","journal-title":"J. Infect. Dis."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1128\/CMR.12.1.80","article-title":"Candida glabrata: Review of epidemiology, pathogenesis, and clinical disease with comparison to C. albicans","volume":"12","author":"Fidel","year":"1999","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1111\/1469-0691.12039","article-title":"ESCMID* guideline for the diagnosis and management of Candida diseases 2012: Non-neutropenic adult patients","volume":"18","author":"Cornely","year":"2012","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1097\/CCM.0000000000002867","article-title":"Initial Antifungal Strategy Reduces Mortality in Critically Ill Patients With Candidemia: A Propensity Score\u2013Adjusted Analysis of a Multicenter Study*","volume":"46","author":"Sierra","year":"2018","journal-title":"Crit. Care Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1007\/s00134-023-07034-7","article-title":"Antifungal stewardship in critically ill patients","volume":"49","author":"Nseir","year":"2023","journal-title":"Intensive Care Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1186\/s13054-020-03265-y","article-title":"(1,3)-\u03b2-d-Glucan-based empirical antifungal interruption in suspected invasive candidiasis: A randomized trial","volume":"24","author":"Posteraro","year":"2020","journal-title":"Crit. Care"},{"key":"ref_17","unstructured":"Cornely, O., Pappas, P.G., Krause, R., Miller, R., Ostrosky-Zeichner, L., Vazquez, J., Sanders, J.W., Munoz, P., Spec, A., and Thompson, G.R. (2022, January 23\u201326). Oral Ibrexafungerp Outcomes in Patients with Invasive Candidiasis and Candidemia from the FURI and CARES Studies. Proceedings of the ECCMID, Lisbon, Portugal. Poster."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"119","DOI":"10.4161\/viru.22913","article-title":"Candida albicanspathogenicity mechanisms","volume":"4","author":"Mayer","year":"2013","journal-title":"Virulence"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1797","DOI":"10.1007\/s10096-020-03912-w","article-title":"Mechanism of Candida pathogenesis: Revisiting the vital drivers","volume":"39","author":"Mba","year":"2020","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1569","DOI":"10.1093\/jac\/dkad139","article-title":"Invasive candidiasis: Current clinical challenges and unmet needs in adult populations","volume":"78","author":"Soriano","year":"2023","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1247","DOI":"10.1093\/infdis\/167.5.1247","article-title":"Secular trends in the epidemiology of nosocomial fungal infections in the United States, 1980-1990. National Nosocomial Infections Surveillance System","volume":"167","author":"Jarvis","year":"1993","journal-title":"J. Infect. Dis."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"18026","DOI":"10.1038\/nrdp.2018.26","article-title":"Invasive Candidiasis","volume":"4","author":"Pappas","year":"2018","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"e449","DOI":"10.1093\/cid\/ciaa193","article-title":"Burden of Candidemia in the United States, 2017","volume":"71","author":"Tsay","year":"2020","journal-title":"Clin. Infect. Dis."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1186\/s13054-019-2497-3","article-title":"Incidence and outcome of invasive candidiasis in intensive care units (ICUs) in Europe: Results of the EUCANDICU project","volume":"23","author":"Bassetti","year":"2019","journal-title":"Crit. Care"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"502","DOI":"10.1007\/s00134-024-07341-7","article-title":"Invasive Fungal Diseases in Adult Patients in Intensive Care Unit (FUNDICU): 2024 consensus definitions from ESGCIP, EFISG, ESICM, ECMM, MSGERC, ISAC, and ISHAM","volume":"50","author":"Bassetti","year":"2024","journal-title":"Intensive Care Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1478","DOI":"10.1001\/jama.2020.2717","article-title":"Prevalence and Outcomes of Infection Among Patients in Intensive Care Units in 2017","volume":"323","author":"Vincent","year":"2020","journal-title":"JAMA"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1016\/j.chest.2021.08.081","article-title":"Risk Factors for Invasive Candida Infection in Critically Ill Patients: A Systematic Review and Meta-analysis","volume":"161","author":"Schlattmann","year":"2022","journal-title":"Chest"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1086\/647373","article-title":"Epidemiology, diagnosis, and therapy of fungal infections in surgery","volume":"17","author":"Giamarellou","year":"1996","journal-title":"Infect. Control Hosp. Epidemiol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"910","DOI":"10.1089\/sur.2023.149","article-title":"Identification of Risk Factors for Intra-Abdominal Candidiasis","volume":"24","author":"Habighorst","year":"2023","journal-title":"Surg. Infect."},{"key":"ref_30","unstructured":"Rex, J.H. (2000, January 8\u201312). Treatment of candidemia in the non-neutropenic host. Proceedings of the 14th Congress of the International Society for Human and Animal Mycology, Buenos Aires, Argentina. Speaker in symposium entitled \u201cSuperficial and invasive infections caused by Candida and other emerging yeasts.\u201d."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1097\/00001432-200312000-00004","article-title":"New approaches to the risk of Candida in the intensive care unit","volume":"16","year":"2003","journal-title":"Curr. Opin. Infect. Dis."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e01909-17","DOI":"10.1128\/JCM.01909-17","article-title":"Diagnosing Invasive Candidiasis","volume":"56","author":"Clancy","year":"2018","journal-title":"J. Clin. Microbiol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1284","DOI":"10.1093\/cid\/cit006","article-title":"Finding the \u201cMissing 50%\u201d of invasive candidiasis: How nonculture diagnostics will improve understanding of disease spectrum and transform patient care","volume":"56","author":"Clancy","year":"2013","journal-title":"Clin. Infect. Dis."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"3640","DOI":"10.1128\/AAC.49.9.3640-3645.2005","article-title":"Delaying the Empiric Treatment of Candida Bloodstream Infection until Positive Blood Culture Results Are Obtained: A Potential Risk Factor for Hospital Mortality","volume":"49","author":"Morrell","year":"2005","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"562","DOI":"10.4065\/75.6.562","article-title":"Comparison of Premortem Clinical Diagnoses in Critically Ill Patients and Subsequent Autopsy Findings","volume":"75","author":"Roosen","year":"2000","journal-title":"Mayo Clin. Proc."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"2001","DOI":"10.1007\/s00134-020-06240-x","article-title":"Invasive candidiasis in critical care: Challenges and future directions","volume":"46","author":"Logan","year":"2020","journal-title":"Intensive Care Med."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"181","DOI":"10.5858\/arpa.2014-0230-RS","article-title":"Application of the 1,3-\u03b2-d-Glucan (Fungitell) Assay in the Diagnosis of Invasive Fungal Infections","volume":"140","author":"Tran","year":"2016","journal-title":"Arch. Pathol. Lab. Med."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"650","DOI":"10.1055\/s-0035-1562892","article-title":"Role of Non-Culture-Based Tests, with an Emphasis on Galactomannan Testing for the Diagnosis of Invasive Aspergillosis","volume":"36","author":"Maertens","year":"2015","journal-title":"Semin. Respir. Crit. Care Med."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1136\/jclinpath-2017-204692","article-title":"Diagnostic accuracy of fungal PCR and \u03b2-d-glucan for detection of candidaemia: A preliminary evaluation","volume":"71","author":"McKeating","year":"2018","journal-title":"J. Clin. Pathol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1093\/cid\/cis456","article-title":"(1,3)-D-Glucan as a prognostic marker of treatment response in invasive candidiasis","volume":"55","author":"Jaijakul","year":"2012","journal-title":"Clin. Infect. Dis."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"892","DOI":"10.1093\/cid\/ciu959","article-title":"T2 magnetic resonance assay for the rapid diagnosis of candidemia in whole blood: A clinical trial","volume":"60","author":"Mylonakis","year":"2015","journal-title":"Clin. Infect. Dis."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Clancy, C.J., and Nguyen, M.H. (2018). Non-Culture Diagnostics for Invasive Candidiasis: Promise and Unintended Consequences. J. Fungi, 4.","DOI":"10.3390\/jof4010027"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1975","DOI":"10.1111\/liv.15648","article-title":"Fungal translocation measured by serum 1,3-\u00df-D-glucan correlates with severity and outcome of liver cirrhosis\u2014A pilot study","volume":"43","author":"Egger","year":"2023","journal-title":"Liver Int."},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Hoenigl, M., P\u00e9rez-Santiago, J., Nakazawa, M., de Oliveira, M.F., Zhang, Y., Finkelman, M.A., Letendre, S., Smith, D., and Gianella, S. (2016). (1\u21923)-\u03b2-d-Glucan: A Biomarker for Microbial Translocation in Individuals with Acute or Early HIV Infection?. Front. Immunol., 7.","DOI":"10.3389\/fimmu.2016.00404"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1165","DOI":"10.2217\/fmb-2018-0079","article-title":"Use of T2MR in invasive candidiasis with and without candidemia","volume":"13","author":"Zacharioudakis","year":"2018","journal-title":"Futur. Microbiol."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Tang, D.-L., Chen, X., Zhu, C.-G., Li, Z.-W., Xia, Y., and Guo, X.-G. (2019). Pooled analysis of T2 Candida for rapid diagnosis of candidiasis. BMC Infect. Dis., 19.","DOI":"10.1186\/s12879-019-4419-z"},{"key":"ref_47","first-page":"1","article-title":"Nosocomial Candidiasis: Antifungal Stewardship and the Importance of Rapid Diagnosis","volume":"54","author":"Pfaller","year":"2016","journal-title":"Med. Mycol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1186\/s13054-016-1313-6","article-title":"Diagnosis and management of invasive candidiasis in the ICU: An updated approach to an old enemy","volume":"20","author":"Calandra","year":"2016","journal-title":"Crit. Care"},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Camp, I., Spettel, K., and Willinger, B. (2020). Molecular Methods for the Diagnosis of Invasive Candidiasis. J. Fungi, 6.","DOI":"10.3390\/jof6030101"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1677","DOI":"10.1093\/cid\/ciab158","article-title":"Clinical Accuracy and Impact of Plasma Cell-Free DNA Fungal Polymerase Chain Reaction Panel for Noninvasive Diagnosis of Fungal Infection","volume":"73","author":"Senchyna","year":"2021","journal-title":"Clin. Infect. Dis."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"e206","DOI":"10.1017\/ash.2023.475","article-title":"Problems with etiologic diagnosis of community-acquired pneumonia using plasma microbial cell-free DNA sequencing","volume":"3","author":"Musher","year":"2023","journal-title":"Antimicrob. Steward. Healthc. Epidemiol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1038\/s41591-020-1105-z","article-title":"Rapid pathogen detection by metagenomic next-generation sequencing of infected body fluids","volume":"27","author":"Gu","year":"2021","journal-title":"Nat. Med."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1146\/annurev-pathmechdis-012418-012751","article-title":"Clinical Metagenomic Next-Generation Sequencing for Pathogen Detection","volume":"14","author":"Gu","year":"2019","journal-title":"Annu. Rev. Pathol. Mech. Dis."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1093\/cid\/civ933","article-title":"Clinical Practice Guideline for the Management of Candidiasis: 2016 Update by the Infectious Diseases Society of America","volume":"62","author":"Pappas","year":"2016","journal-title":"Clin. Infect. Dis."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"ofae663","DOI":"10.1093\/ofid\/ofae663","article-title":"Do Patients With Candidemia Need an Ophthalmologic Examination?","volume":"11","author":"Lehman","year":"2024","journal-title":"Open Forum Infect. Dis."},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Zilberberg, M.D., Kollef, M.H., Arnold, H., Labelle, A., Micek, S.T., Kothari, S., and Shorr, A.F. (2010). Inappropriate empiric antifungal therapy for candidemia in the ICU and hospital resource utilization: A retrospective cohort study. BMC Infect. Dis., 10.","DOI":"10.1186\/1471-2334-10-150"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1739","DOI":"10.1093\/cid\/cis305","article-title":"Septic Shock Attributed to Candida Infection: Importance of Empiric Therapy and Source Control","volume":"54","author":"Kollef","year":"2012","journal-title":"Clin. Infect. Dis."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1555","DOI":"10.1001\/jama.2016.14655","article-title":"Empirical Micafungin Treatment and Survival Without Invasive Fungal Infection in Adults With ICU-Acquired Sepsis, Candida Colonization, and Multiple Organ Failure: The EMPIRICUS Randomized Clinical Trial","volume":"316","author":"Timsit","year":"2016","journal-title":"JAMA"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1219","DOI":"10.1093\/cid\/ciu074","article-title":"MSG-01: A randomized, double-blind, placebo-controlled trial of caspofungin prophylaxis followed by preemptive therapy for invasive candidiasis in high-risk adults in the critical care setting","volume":"58","author":"Shoham","year":"2014","journal-title":"Clin. Infect. Dis."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1671","DOI":"10.1093\/cid\/civ707","article-title":"A randomized, placebo-controlled trial of preemptive antifungal therapy for the prevention of invasive candidiasis following gastrointestinal surgery for intra-abdominal infections","volume":"61","author":"Knitsch","year":"2015","journal-title":"Clin. Infect. Dis."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"83","DOI":"10.7326\/0003-4819-149-2-200807150-00004","article-title":"Empirical fluconazole versus placebo for intensive care unit patients: A randomized trial","volume":"149","author":"Schuster","year":"2008","journal-title":"Ann. Intern. Med."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"1077","DOI":"10.1007\/s00134-015-3791-4","article-title":"Outcomes associated with routine systemic antifungal therapy in critically ill patients with Candida colonization","volume":"41","author":"Ferreira","year":"2015","journal-title":"Intensive Care Med."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"2880","DOI":"10.1093\/jac\/dkr394","article-title":"Antifungal use influences Candida species distribution and susceptibility in the intensive care unit","volume":"66","author":"Fournier","year":"2011","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_64","doi-asserted-by":"crossref","unstructured":"Thomaz, D.Y., de Almeida, J.N., Sejas, O.N.E., Del Negro, G.M.B., Carvalho, G.O.M.H., Gimenes, V.M.F., de Souza, M., Arastehfar, A., Camargo, C., and Motta, A. (2021). Environmental Clonal Spread of Azole-Resistant Candida parapsilosis with Erg11-Y132F Mutation Causing a Large Candidemia Outbreak in a Brazilian Cancer Referral Center. J. Fungi, 7.","DOI":"10.3390\/jof7040259"},{"key":"ref_65","doi-asserted-by":"crossref","unstructured":"Arastehfar, A., Hilmio\u011flu-Polat, S., Daneshnia, F., Pan, W., Hafez, A., Fang, W., Liao, W., \u015eahbudak-Bal, Z., Metin, D.Y., and De Almeida, J.N. (2021). Clonal Candidemia Outbreak by Candida parapsilosis Carrying Y132F in Turkey: Evolution of a Persisting Challenge. Front. Cell. Infect. Microbiol., 11.","DOI":"10.3389\/fcimb.2021.676177"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"2506","DOI":"10.1093\/jac\/dks256","article-title":"Adherence to recommendations for the use of antifungal agents in a tertiary care hospital","volume":"67","author":"Nivoix","year":"2012","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"e01464-17","DOI":"10.1128\/AAC.01464-17","article-title":"Overtreatment of Asymptomatic Candiduria among Hospitalized Patients: A Multi-institutional Study","volume":"62","author":"Jacobs","year":"2017","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"S175","DOI":"10.1093\/infdis\/jiaa394","article-title":"Core Recommendations for Antifungal Stewardship: A Statement of the Mycoses Study Group Education and Research Consortium","volume":"222","author":"Johnson","year":"2020","journal-title":"J. Infect. Dis."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1007\/s12281-024-00489-1","article-title":"Empirical Therapy for Invasive Candidiasis in Critically Ill Patients","volume":"18","author":"Bartalucci","year":"2024","journal-title":"Curr. Fungal Infect. Rep."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"iv27","DOI":"10.1093\/jac\/dky046","article-title":"Impact of rapid, culture-independent diagnosis of candidaemia and invasive candidiasis in a community health system","volume":"73","author":"Patch","year":"2018","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"ofad538","DOI":"10.1093\/ofid\/ofad538","article-title":"Stewardship-Guided T2Candida Testing Shortens Time to Antifungal Treatment and Reduces Antifungal Usage Among Medical Intensive Care Unit Patients With Septic Shock","volume":"10","author":"Shields","year":"2023","journal-title":"Open Forum Infect. Dis."},{"key":"ref_72","doi-asserted-by":"crossref","unstructured":"Helweg-Larsen, J., Steensen, M., Pedersen, F.M., Jensen, P.B., Perch, M., M\u00f8ller, K., Olesen, B.R., S\u00f8derlund, M., and Arendrup, M.C. (2021). Intensive Care Antifungal Stewardship Programme Based on T2Candida PCR and Candida Mannan Antigen: A Prospective Study. J. Fungi, 7.","DOI":"10.3390\/jof7121044"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.ijid.2020.01.037","article-title":"Evaluation of first-line therapies for the treatment of candidemia in ICU patients: A propensity score analysis","volume":"93","author":"Bienvenu","year":"2020","journal-title":"Int. J. Infect. Dis."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"789","DOI":"10.1007\/s00134-019-05599-w","article-title":"ESICM\/ESCMID task force on practical management of invasive candidiasis in critically ill patients","volume":"45","author":"Antonelli","year":"2019","journal-title":"Intensive Care Med."},{"key":"ref_75","doi-asserted-by":"crossref","unstructured":"Szyma\u0144ski, M., Chmielewska, S., Czy\u017cewska, U., Malinowska, M., and Tylicki, A. (2022). Echinocandins\u2013structure, mechanism of action and use in antifungal therapy. Journal of Enzyme Inhibition and Medicinal Chemistry, Taylor and Francis Ltd.","DOI":"10.1080\/14756366.2022.2050224"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1093\/cid\/cix744","article-title":"Approach to the Investigation and Management of Patients With Candida auris, an Emerging Multidrug-Resistant Yeast","volume":"66","author":"Tsay","year":"2018","journal-title":"Clin. Infect. Dis."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"514","DOI":"10.15585\/mmwr.mm6619a7","article-title":"Notes from the Field: Ongoing Transmission of Candida auris in Health Care Facilities\u2014United States, June 2016\u2013May 2017","volume":"66","author":"Tsay","year":"2017","journal-title":"Mmwr-Morbidity Mortal. Wkly. Rep."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1007\/978-3-319-25304-6_14","article-title":"Antifungals: Mechanism of action and drug resistance","volume":"892","author":"Prasad","year":"2016","journal-title":"Adv. Exp. Med. Biol."},{"key":"ref_79","doi-asserted-by":"crossref","unstructured":"Cavalheiro, M., and Teixeira, M.C. (2018). Candida Biofilms: Threats, Challenges, and Promising Strategies. Front. Med., 5.","DOI":"10.3389\/fmed.2018.00028"},{"key":"ref_80","doi-asserted-by":"crossref","unstructured":"Vazquez, J., Reboli, A.C., Pappas, P.G., Patterson, T.F., Reinhardt, J., Chin-Hong, P., Tobin, E., Kett, D.H., Biswas, P., and Swanson, R. (2014). Evaluation of an early step-down strategy from intravenous anidulafungin to oral azole therapy for the treatment of candidemia and other forms of invasive candidiasis: Results from an open-label trial. BMC Infect. Dis., 14.","DOI":"10.1186\/1471-2334-14-97"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"1931","DOI":"10.1007\/s00134-015-4053-1","article-title":"Antifungal de-escalation was not associated with adverse outcome in critically ill patients treated for invasive candidiasis: Post hoc analyses of the AmarCAND2 study data","volume":"41","author":"Bailly","year":"2015","journal-title":"Intensive Care Med."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"ofab250","DOI":"10.1093\/ofid\/ofab250","article-title":"Early Stepdown From Echinocandin to Fluconazole Treatment in Candidemia: A Post Hoc Analysis of Three Cohort Studies","volume":"8","author":"Gariup","year":"2021","journal-title":"Open Forum Infect. Dis."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1186\/s13613-018-0392-8","article-title":"De-escalation of antifungal treatment in critically ill patients with suspected invasive Candida infection: Incidence, associated factors, and safety","volume":"8","author":"Jaffal","year":"2018","journal-title":"Ann. Intensive Care"},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"1668","DOI":"10.1007\/s00134-017-4932-8","article-title":"Biomarker-based strategy for early discontinuation of empirical antifungal treatment in critically ill patients: A randomized controlled trial","volume":"43","author":"Loridant","year":"2017","journal-title":"Intensive Care Med."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1007\/s00134-014-3310-z","article-title":"A multicenter study of septic shock due to candidemia: Outcomes and predictors of mortality","volume":"40","author":"Bassetti","year":"2014","journal-title":"Intensive Care Med."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1080\/14656566.2021.1890026","article-title":"An evaluation of ibrexafungerp for the treatment of invasive candidiasis: The evidence to date","volume":"22","author":"Colombo","year":"2021","journal-title":"Expert Opin. Pharmacother."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1002\/phar.2926","article-title":"Management of invasive candidiasis: A focus on rezafungin, ibrexafungerp, and fosmanogepix","volume":"44","author":"August","year":"2024","journal-title":"Pharmacother. J. Hum. Pharmacol. Drug Ther."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"e0141922","DOI":"10.1128\/aac.01419-22","article-title":"Clinical Efficacy and Safety of a Novel Antifungal, Fosmanogepix, in Patients with Candidemia Caused by Candida auris : Results from a Phase 2 Trial","volume":"67","author":"Vazquez","year":"2023","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"2471","DOI":"10.1093\/jac\/dkad256","article-title":"Clinical safety and efficacy of novel antifungal, fosmanogepix, for the treatment of candidaemia: Results from a Phase 2 trial","volume":"78","author":"Pappas","year":"2023","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"e02614-17","DOI":"10.1128\/AAC.02614-17","article-title":"Overcoming the resistance hurdle: Pharmacokinetic-pharmacodynamic target attainment analyses for rezafungin (CD101) against Candida albicans and Candida glabrata","volume":"62","author":"Bader","year":"2018","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1080\/14656566.2024.2331775","article-title":"An evaluation of rezafungin: The latest treatment option for adults with invasive candidiasis An Evaluation of Rezafungin: The latest treatment option for adults with candidemia and invasive candidiasis","volume":"25","author":"Sharma","year":"2024","journal-title":"Expert Opin. Pharmacother."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"e3647","DOI":"10.1093\/cid\/ciaa1380","article-title":"Rezafungin Versus Caspofungin in a Phase 2, Randomized, Double-blind Study for the Treatment of Candidemia and Invasive Candidiasis: The STRIVE Trial","volume":"73","author":"Thompson","year":"2021","journal-title":"Clin. Infect. Dis."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/S0140-6736(22)02324-8","article-title":"Rezafungin versus caspofungin for treatment of candidaemia and invasive candidiasis (ReSTORE): A multicentre, double-blind, double-dummy, randomised phase 3 trial","volume":"401","author":"Thompson","year":"2023","journal-title":"Lancet"},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"1429","DOI":"10.1007\/s00134-014-3355-z","article-title":"Candida colonization index and subsequent infection in critically ill surgical patients: 20 years later","volume":"40","author":"Eggimann","year":"2014","journal-title":"Intensive Care Med."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1097\/00000658-199412000-00008","article-title":"Candida colonization and subsequent infections in critically ill surgical patients","volume":"220","author":"Pittet","year":"1994","journal-title":"Ann. Surg."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"R249","DOI":"10.1186\/cc10507","article-title":"Early diagnosis of candidemia in intensive care unit patients with sepsis: A prospective comparison of (1\u21923)-\u03b2-D-glucan assay, Candida score, and colonization index","volume":"15","author":"Posteraro","year":"2011","journal-title":"Crit. Care"},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1111\/j.1439-0507.2009.01756.x","article-title":"Improvement of a clinical prediction rule for clinical trials on prophylaxis for invasive candidiasis in the intensive care unit","volume":"54","author":"Pappas","year":"2011","journal-title":"Mycoses"},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"1017","DOI":"10.1186\/cc10544","article-title":"Is (1\u21923)-\u03b2-D-glucan the missing link from bedside assessment to pre-emptive therapy of invasive candidiasis?","volume":"15","author":"Eggimann","year":"2011","journal-title":"Crit. 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