Candida Spp. in the respiratory tract : a real causality with worse outcomes or just a marker of severity?

• Candida spp. is the most common cause of intensive care unit (ICU)
invasive fungal infections worldwide.
• The isolation of Candida spp. from respiratory tract secretions of
non-immunocompromised, mechanically ventilated patients varies
between 20% and 55%, but it might represent colonisation rather
than infection.
• Candida spp. colonisation promotes bacterial pneumonia in animal
models.
• Candida spp. colonisation could clinically increase the risk for Pseudomonas
aeruginosa ventilator-associated pneumonia, prolong
mechanical ventilation and stay and worsen outcomes, but to date
contrasting data are available.
• Available evidence is not sufficient to support routine antifungal
therapy in non-immunocompromised patients.