Utilisation of the colonisation index.

In a retrospective study, 2,238 mycologic samples obtained in 1999 from 89 patients hospitalised in an intensive care unit dedicated to digestive dise ases were analysed. Feasability of monitoring fungal colonisation and impli cations for workload and costs were assessed. From this experience, we conf irmed the ability of the Pittet index to indentify patients at high risk fo r Candida infection. Monitoring of Pittet index required a high degree of c ooperation between the intensive care unit and the laboratory of mycology, and a precise definition of the modalities of sampling. It entailed a signi ficant increase in costs and workload. A treatment was started whenever a c olonisation index greater than or equal to 0.5 was associated with severe c linical or biological signs. This involved an increase of the expense of an tifungal drugs. The potential benefits could not be evaluated from our stud y. Direct observation of pseudomycelium in the samples and candiduria were significantly correlated to fungal colonisation. (C) 2001 Editions scientif iques et medicales Elsevier SAS.