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

\u2022 Candida spp. is the most common cause of intensive care unit (ICU) invasive fungal infections worldwide. \u2022 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. \u2022 Candida spp. colonisation promotes bacterial pneumonia in animal models. \u2022 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. \u2022 Available evidence is not sufficient to support routine antifungal therapy in non-immunocompromised patients