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      Thursday, June 8, 2023
      News & Perspective Drugs & Diseases CME & Education Academy Video Decision Point
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      CPD

      An Overlooked Cause of Preventable Deaths in the ICU: Invasive Fungal Infections

      • Authors: Matteo Bassetti, MD, PhD; Ignacio Martin-Loeches, PhD, JFICMI; George R. Thompson, MD, FIDSA, FECMM
      • CPD Released: 5/26/2022
      • THIS ACTIVITY HAS EXPIRED FOR CREDIT
      • Valid for credit through: 5/26/2023
      Start Activity

      Target Audience and Goal Statement

      This educational activity is intended for an international audience of non-US infectious diseases specialists, critical care specialists, and hematology/oncology specialists.

      The goal of this activity is that learners will be better able to understand the epidemiology, diagnosis, and treatment of suspected invasive fungal infections and novel therapeutic approaches for both treatment and prophylaxis.

      Upon completion of this activity, participants will:

      • Have increased knowledge regarding the
        • Epidemiology of severe fungal infections
        • Current landscape of antifungal therapeutics
        • Novel therapeutics for the treatment and prophylaxis of severe fungal infections

      Disclosures

      WebMD Global requires every individual in a position to control educational content to disclose all financial relationships with ineligible companies that have occurred within the past 24 months. Ineligible companies are organizations whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

      All relevant financial relationships for anyone with the ability to control the content of this educational activity are listed below and have been mitigated. Others involved in the planning of this activity have no relevant financial relationships with ineligible companies.

      Faculty

      • Matteo Bassetti, MD, PhD

        Professor of Infectious Diseases
        Department of Health Science
        University of Genoa
        Head
        Infectious Diseases Clinic
        Hospital Policlinico San Martino – IRCCS
        Genoa, Italy

        Disclosures

        Disclosure: Matteo Bassetti, MD, has the following relevant financial relationships:
        Consultant or advisor for: Angelini Pharma; Cidara Therapeutics; Menarini; MSD; Pfizer; Roche; Shionogi
        Speaker or member of speakers bureau for: Angelini Pharma; Astellas; Bayer; bioMérieux; Cidara Therapeutics; Cipla; Gilead; Menarini; MSD; Pfizer; Shionogi
        Research funding from: Gilead; MSD; Pfizer

      • Ignacio Martin-Loeches, PhD, JFICMI

        Clinical Professor
        School of Medicine
        Trinity College Dublin
        Consultant in Intensive Care Medicine
        St James's Hospital
        CLOD Dublin Midlands Hospital Group
        Dublin, Ireland

        Disclosures

        Disclosure: Ignacio Martin-Loeches, PhD, JFICMI, has the following relevant financial relationships:
        Consultant or advisor for: Gilead; MSD; Mundipharma; Pfizer
        Speaker or member of speakers bureau for: Gilead; MSD; Mundipharma; Pfizer
        Research funding from: Grifols

      • George R. Thompson, MD, FIDSA, FECMM

        Professor of Medicine
        Department of Medicine
        Division of Infectious Diseases
        Department of Medical Microbiology and Immunology
        UC-Davis Medical Center
        Sacramento, California, United States

        Disclosures

        Disclosure: George R. Thompson, MD, FIDSA, FECMM, has the following relevant financial relationships:
        Consultant or advisor for: Amplynx; Astellas; Cidara; F2G; Mayne; Pfizer
        Research funding from: Amplynx; Astellas; Cidara; F2G; Mayne; Pfizer

      Editors

      • Alessia Piazza, PhD

        Medical Education Director, WebMD Global, LLC

        Disclosures

        Disclosure: Alessia Piazza, PhD, has no relevant financial relationships.

      • Diana Lucifero, PhD

        Scientific Content Manager, WebMD Global, LLC

        Disclosures

        Disclosure: Diana Lucifero, PhD, has no relevant financial relationships. 

      Compliance Reviewer

      • Leigh Schmidt, MSN, RN, CMSRN, CNE, CHCP

        Associate Director, Accreditation and Compliance

        Disclosures

        Disclosure: Leigh Schmidt, MSN, RN, CMSRN, CNE, CHCP, has no relevant financial relationships.

      Accreditation Statements

        For Physicians

      • The Faculty of Pharmaceutical Medicine of the Royal Colleges of Physicians of the United Kingdom (FPM) has reviewed and approved the content of this educational activity and allocated it 1.0 continuing professional development credits (CPD).

        Contact WebMD Global

      For questions regarding the content of this activity, contact the accredited provider for this CME/CE activity noted above. For technical assistance, contact [email protected]

      Instructions for Participation and Credit

      There are no fees for participating in or receiving credit for this online educational activity. For information about your eligibility to claim credit, please consult your professional licensing board.

      This activity is designed to be completed within the time designated on the title page; physicians should claim only those credits that reflect the time actually spent participating in the activity. To successfully earn credit, participants must complete the activity online during the credit eligibility period that is noted on the title page.

      Follow these steps to claim a credit certificate for completing this activity:

      1. Read the information provided on the title page regarding the target audience, learning objectives, and author disclosures, read and study the activity content and then complete the post-test questions. If you earn a passing score on the post-test and we have determined based on your registration profile that you may be eligible to claim CPD credit for completing this activity, we will issue you a CPD credit certificate.
      2. Once your CPD credit certificate has been issued, you may view and print the certificate from your CME/CE Tracker. CPD credits will be tallied in your CME/CE Tracker and archived for 6 years; at any point within this time period you can print out the tally as well as the certificates by accessing "Edit Your Profile" at the top of the Medscape Education homepage.

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      You may now view or print the certificate from your CME/CE Tracker. You may print the certificate but you cannot alter it. Credits will be tallied in your CME/CE Tracker and archived for 6 years; at any point within this time period you can print out the tally as well as the certificates by accessing "Edit Your Profile" at the top of your Medscape homepage.

      *The credit that you receive is based on your user profile.

      < Invasive Fungal Infections: Contemporary Approaches to Diagnosis, Treatment, and Prophylaxis
      From Medscape Education
      CPD

      An Overlooked Cause of Preventable Deaths in the ICU: Invasive Fungal Infections

      Authors: Matteo Bassetti, MD, PhD; Ignacio Martin-Loeches, PhD, JFICMI; George R. Thompson, MD, FIDSA, FECMMFaculty and Disclosures
      THIS ACTIVITY HAS EXPIRED FOR CREDIT

      CPD Released: 5/26/2022

      Valid for credit through: 5/26/2023

      processing....

      References

      1. Bassetti M, et al. Intensive care medicine research agenda on invasive fungal infection in critically ill patients. Intensive Care Med. 2017;43:1225-1238.
      2. Pfaller MA, et al. Invasive fungal pathogens: current epidemiological trends. Clin Infect Dis. 2006;43(Supplement_1):S3-S14.
      3. Donnelly JP, 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. 2019;71:1367-1376.
      4. Pappas PG, et al. Invasive candidiasis. Nat Rev Dis Primers. 2018;4:18026.
      5. Bassetti M, et al. Diagnosis and treatment of candidemia in the intensive care unit. Semin Respir Crit Care Med. 2019;40:524-539.
      6. Verweij PE, et al. Review of influenza-associated pulmonary aspergillosis in ICU patients and proposal for a case definition: an expert opinion. Intensive Care Med. 2020;46:1524-1535.
      7. Verweij PE, et al. Taskforce report on the diagnosis and clinical management of COVID-19 associated pulmonary aspergillosis. Intensive Care Med. 2021;47:819-834.
      8. Kontoyiannis DP, et al. Prospective surveillance for invasive fungal infections in hematopoietic stem cell transplant recipients, 2001-2006: overview of the Transplant-Associated Infection Surveillance Network (TRANSNET) Database. Clin Infect Dis. 2010;50:1091-1100.
      9. Pappas PG, et al. Invasive fungal infections among organ transplant recipients: results of the Transplant-Associated Infection Surveillance Network (TRANSNET). Clin Infect Dis. 2010;50:1101-1111.
      10. Webb BJ, et al. Epidemiology and clinical features of invasive fungal infection in a US health care network. Open Forum Infect Dis. 2018;5:ofy187.
      11. Wan Ismail WNA, et al. The economic burden of candidemia and invasive candidiasis: a systematic review. Value Health Reg Issues. 2020;21:53-58.
      12. Krueger KP, et al. Economic considerations in the treatment of invasive aspergillosis: a review of voriconazole pharmacoeconomic studies. Clinicoecon Outcomes Res. 2009;1:35-43.
      13. Dignani MC. Epidemiology of invasive fungal diseases on the basis of autopsy reports. F1000Prime Rep. 2014;6:81.
      14. Kullberg BJ, et al. Invasive candidiasis. N Engl J Med. 2015;373:1445-1456.
      15. Martin-Loeches IM, et al. ESICM/ESCMID task force on practical management of invasive candidiasis in critically ill patients. Intensive Care Med. 2019;45:789-805.
      16. Patterson TF, et al. Practice guidelines for the diagnosis and management of aspergillosis: 2016 update by the Infectious Diseases Society of America. Clin Infect Dis. 2016;63:e1-e60.
      17. Ullmann AJ, et al. Diagnosis and management of Aspergillus diseases: executive summary of the 2017 ESCMID-ECMM-ERS guideline. Clin Microbiol Infect. 2018;24:e1-e38.
      18. Poissy JL, et al. Risk factors for candidemia: a prospective matched case-control study. Crit Care. 2020;24:109.
      19. Thomas-Rüddel DO, et al. Risk factors for invasive candida infection in critically ill patients: a systematic review and meta-analysis. Chest. 2022;161:345-355.
      20. Pfaller MA, et al. Epidemiology of invasive candidiasis: a persistent public health problem. Clin Microbiol Rev. 2007;20:133-163.
      21. Beed MR, et al. Fungal infections and critically ill adults. Continuing Education in Anaesthesia Critical Care and Pain. BJA Educ. 2014;14:262-267.
      22. Ghannoum MA, et al. Antifungal agents: mode of action, mechanisms of resistance, and correlation of these mechanisms with bacterial resistance. Clin Microbiol Rev. 1999;12:501-517.
      23. Houšť JJ, et al. Antifungal drugs. Metabolites. 2020;10:106.
      24. Natamycin ophthalmic suspension [prescribing information]. Approved 1978. Revised May 2008.
      25. Semis RS, et al. Mechanism of activity and toxicity of nystatin-intralipid. Med Mycol. 2013;51:422-431.
      26. Brüggemann RJM, et al. Clinical relevance of the pharmacokinetic interactions of azole antifungal drugs with other coadministered agents. Clin Infect Dis. 2009;48:1441-1458.
      27. Chang Y-L, et al. New facets of antifungal therapy. Virulence. 2017;8:222-236.
      28. Yang Y-L, et al. Adverse effects associated with currently commonly used antifungal agents: a network meta-analysis and systematic review. Front Pharmacol. 2021;12:697330.
      29. Kett DH, et al. Anidulafungin compared with fluconazole in severely ill patients with candidemia and other forms of invasive candidiasis: support for the 2009 IDSA treatment guidelines for candidiasis. Crit Care. 2011;15:R253.
      30. Cornely OA, et al. ESCMID* guideline for the diagnosis and management of Candida diseases 2012: non-neutropenic adult patients. Clin Microbiol Infect. 2012;18(Suppl 7):19-37.
      31. Grover ND Echinocandins: a ray of hope in antifungal drug therapy. Indian J Pharmacol. 2010;42:9-11.
      32. Ellis ME, et al. Fungal endocarditis: evidence in the world literature, 1965-1995. Clin Infect Dis. 2001;32:50-62.
      33. Pappas PG, et al. Clinical practice guideline for the management of candidiasis: 2016 update by the Infectious Diseases Society of America. Clin Infect Dis. 2016;62:e1-e50.
      34. Rauseo AM, et al. Hope on the horizon: novel fungal treatments in development. Open Forum Infect Dis. 2020;7:ofaa016.
      35. US Food and Drug Administration [email protected]: FDA-Approved Drugs. Accessed February 21, 2022. https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm
      36. Jallow S, et al. Ibrexafungerp: a first-in-class oral triterpenoid glucan synthase inhibitor. J Fungi (Basel). 2021;7:163.
      37. Ibrexafungerp [prescribing information]. Approved 2021. Revised June 2021.
      38. Kontoyiannis DP. Antifungal resistance: an emerging reality and a global challenge. J Infect Dis. 2017;216(suppl_3):S431-S435.
      39. Vermeulen EK, et al. Azole resistance in Aspergillus fumigatus: a growing public health concern. Curr Opin Infect Dis. 2013;26:493-500.
      40. Verweij PE, et al. International expert opinion on the management of infection caused by azole-resistant Aspergillus fumigatus. Drug Resist Updat. 2015;21-22:30-40.
      41. Spivak ES, et al. Candida auris: an emerging fungal pathogen. J Clin Microbiol. 2018;56:e01588-17.
      42. Johnson MD, et al. Core recommendations for antifungal stewardship: a statement of the Mycoses Study Group Education and Research Consortium. J Infect Dis. 2002;222(Suppl 3):S175-S198.
      « Return to: An Overlooked Cause of Preventable Deaths in the ICU: Invasive Fungal Infections
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