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These updated guidelines replace the previous management guidelines published in 2001. The guidelines are intended for use by health care providers who care for patients who either have these infections or may be at risk for them. General 1. Catheter cultures should be performed when a catheter is removed for suspected catheter-related bloodstream infection(More)
BACKGROUND Azole resistance is an emerging problem in Aspergillus fumigatus and complicates the management of patients with Aspergillus-related diseases. Selection of azole resistance may occur through exposure to azole fungicides in the environment. In the Netherlands a surveillance network was used to investigate the epidemiology of resistance selection(More)
OBJECTIVE To find a subset of patients with suspected central venous catheter (CVC)-related infection (CRI) in whom CVC removal is not needed. DESIGN Randomized controlled trial. SETTING Thirty-three-bed ICU. PATIENTS AND PARTICIPANTS One hundred and forty four patients with suspected CRI in which a change of CVCs was planned were evaluated for(More)
In clinical trials, the incidence of catheter-tip colonization (CTC) is frequently used as a surrogate end point for the incidence of catheter-related bloodstream infection (BSI). It is not clear whether the correlation between CTC and catheter-related BSI is good. We searched the MEDLINE database and conducted a literature search for the years 1990-2002(More)
BACKGROUND Invasive pulmonary aspergillosis (IPA) is a significant problem in patients with chemotherapy-induced prolonged neutropenia. Because pulmonary deposition of conidia is the first step in developing IPA, we hypothesized that inhalation of liposomal amphotericin B would prevent IPA. METHODS We performed a randomized, placebo-controlled trial of(More)
To investigate whether institution of maximal sterile barrier precautions (SBPs) during arterial catheter (AC) insertion prevents catheter colonization, as is the case for central venous catheters (CVCs), a randomized study was conducted. Three hundred seventy-three patients in whom a radial or dorsalis pedis AC was going to be inserted were randomized to(More)
At present, voriconazole (VOR) is the drug of first choice for treating invasive pulmonary aspergillosis (IPA). However, particularly in advanced stages of disease and in the severely immunocompromised host, the mortality remains substantial. The combination of VOR with an echinocandin may improve the therapeutic outcome. We investigate here whether(More)
BACKGROUND Invasive aspergillosis (IA) is a leading cause of mortality in patients with acute leukemia. Management of IA is expensive, which makes prevention desirable. Because hospital resources are limited, prevention costs have to be compared with treatment costs and outcome. METHODS In 269 patients treated for acute myelogenous(More)
OBJECTIVES Voriconazole, like all other antifungals of the azole group, is potentially hepatotoxic. A large interpatient variability of liver enzyme elevations during oral or intravenous (iv) voriconazole administration is observed. This interpatient variability may be explained by differences in voriconazole metabolism because of cytochrome P450(More)
Azole resistance in Aspergillus fumigatus is increasingly reported. Here, we describe the validation of the AsperGenius, a new multiplex real-time PCR assay consisting of two multiplex real-time PCRs, one that identifies the clinically relevant Aspergillus species, and one that detects the TR34, L98H, T289A, and Y121F mutations in CYP51A and differentiates(More)