1092

Abstract

Introduction: Candida blood stream infections are rising worldwide and are the cause of high mortality and increased length of stay in ICU.Most of the recent data is on the usage of echinocandins in non albicans candida.Very few studies are available on the epidemiology of candidemia in ICU in developing world hence this study was initiated. Methods: This is a single center observational study conducted in 35 bed medical ICU over two year period from July 2011 to June 2013.The candidemia was labeled as blood culture positive for candida.The incidence was calculated as per thousand ICU admissions.Percentage of patients who expired with candidemia was recorded.The species of candida and the culture sensitivity was also analysed. Results: There were 21 isolates of candida in blood over a two year period.There were 6006 ICU admissions in the same period.The incidence of candidemia was 3.5 per thousand ICU admissions.Out of 21 patients with candidemia 10 patients expired with mortality rate of 47%.When species wise data was analysed candida albicans was 33% and non albicans was 66%.Out of non albicans candida tropicalis was most common at 24%.The second most common was candida glabrata at 19%.The culture sensitivity pattern was analysed which showed Fluconazole at 90%sensitivity & Voriconazole at 100%.All the isolates were 100%sensitive to Caspofungin and Amphotericin B.Interestingly the incidence of candidemia was significantly less than the current published data.The mortality rate is high showing the need for early recognition of fungal sepsis.Non albicans candida is more but all isolates still retain good sensitivity to azoles implying problem of resistance is minimal in antifungal therapy unlike bacterial infections. Conclusions: Candidemia incidence is much less than reported but carries very high mortality.Candida albicans is commonest species but non albicans candida are more with good sensitivity to azoles .We believe that this should be the empirical therapy of choice in fungal infections though early and aggressive intervention is the need of the hour.