Candida colonization and candiduria in critically ill patients in the intensive care unit

Clinical severity of invasive candidiasis in critically ill patients and existing difficulties in timely diagnosis mean that early empirical therapy, based upon a strict clinical and epidemiological judgement, is required in intensive care unit patients. One school of thought is that the clinical severity and epidemiological burden of this disease warrant prophylaxis in all critically ill patients. In reality, however, there are still many open-ended questions with regard to which variables are most apt for selection of patients requiring prophylactic or empirical treatment. As a consequence of a consistently significant correlation between colonization (one or more Candida-positive cultures from non-sterile sites) and subsequent infection, colonization remains the most universally accepted predictive variable with regard to invasive candidiasis