Candida ICU Resistance (CandiRes)
Research type
Research Study
Full title
Relationship of antifungal exposure to emergence of Candida resistance in Intensive Care patients: a multi-site cohort study
IRAS ID
305864
Contact name
Tihana Bicanic
Contact email
Sponsor organisation
Joint Research and Enterprise Services (JRES)
Duration of Study in the UK
0 years, 8 months, 1 days
Research summary
Candida fungi live on the skin and in the gut without causing harm. If they grow out of control, they can cause infections including candidaemia, a serious bloodstream infection. This risk is higher for people admitted to the Intensive Care Unit (ICU). Candida infections are treated with antifungal medications; however, some types of Candida can become resistant to antifungal drugs, making treatment more difficult. The overuse of antifungal medications is one of the causes of higher resistance to these drugs. We have little information about how Candida develops resistance in the ICU, and about the impact of antifungal drugs.
Study sites have previously audited the management of candidaemia and antifungal prescribing in ICU. These data will be collated to evaluate baseline antifungal use, Candida epidemiology and outcomes of invasive candidiasis across the sites.
This observational study will take place over 6 months at three ICUs in London. We aim to enrol 300 adult ICU patients. Following informed consent, we will collect a baseline blood sample and clinical information and then take twice weekly swabs from the mouth and skin. We will then study the Candida isolates in the laboratory, including their resistance to antifungal drugs, comparing this in patients who previously received or did not receive these drugs.
If a participant develops a serious infection with Candida, we will take repeated blood or drain fluid samples during treatment with antifungals. This will allow us to measure how quickly the infection is cleared, and how this relates to drug resistance or antifungal drug levels. This will help us improve our tools to detect resistance and identify whether a treatment for Candida is working in a given patient, as well as allow researchers to better study antifungal drugs within future research.
REC name
Wales REC 6
REC reference
21/WA/0370
Date of REC Opinion
23 Nov 2021
REC opinion
Further Information Favourable Opinion