Abstract
Candida spp. is one among the major causes of nosocomial infection, with candidemia gaining increasing prevalence worldwide in parallel with mortality rates ranging from 10-49%. Epidemiology and predisposing factors of candidemia have changed since the number of patients receiving transplants and immunosuppressive therapy, the use of broadspectrum antimicrobials, and the number of AIDS patients have increased. Candidemia is more common among patients with subcutaneous and cutaneous candida infections, through percutaneous inoculation. Major predisposing factors for invasive candidiasis includes neutropenia, haematological malignancies, bone marrow transplantation, total parenteral nutrition, chemotherapy, invasive procedures, and immune-suppressive agents. This study analyses the risk factors of immunocompromised patients with candidemia and antibiogram of Candida spp. isolated from ICU patients. To evaluate the prevalence, distribution and antibiogram of Candida spp., associated risk factors, and outcome in candidemia patients. Blood samples received from patients with clinically suspected fungal infections were subjected to gram staining, culture, sugar assimilation & fermentation, Candida Chrome agar (CCA) & Corn meal agar for identification and speciation. Antifungal susceptibility tests were performed by disk-diffusion tests. Among a total of 337 samples received, 22 (6.5%) samples were positive for candida infections, of which Candida tropicalis 9 (41%) was the predominant isolate followed by C. albicans 5 (23%), Candida glabrata 4 (18%), Candida parapsilosis 2 (9%) and Candida krusei 2 (9%). Male patients had a higher prevalence of candidemia 15 (68.2%). Among the age group of 51-70 years, uncontrolled DM(Diabetes mellitus) and CKD (chronic kidney disease) were found to be the predominant co-morbidities with candidemia.
Highlights
Invasive fungal infections are associated with significant health problems, especially nosocomial infections
Among a total of 337 samples received, 22 (6.5%) samples were positive for candida infections, of which Candida tropicalis 9 (41%) was the predominant isolate followed by C. albicans 5 (23%), Candida glabrata 4 (18%), Candida parapsilosis 2 (9%), and Candida krusei 2 (9%)
Candida non-albicans have immensely replaced Candida albicans in majority of candida infections, the distribution of species varies with the geographical region and patient population.[1,2,3]
Summary
Invasive fungal infections are associated with significant health problems, especially nosocomial infections. Among which one-fourth of blood-stream infections (BSI) are caused by Candida species. Candida non-albicans have immensely replaced Candida albicans in majority of candida infections, the distribution of species varies with the geographical region and patient population.[1,2,3]. Candida tropicalis has been found to be the major fungal isolate from blood stream infection/candidemia in India and Taiwan, whereas Candida parapsilosis and Candida glabrata have been found to be prominent in China and the US respectively.[2,4] Candida has been reported as the fourth to sixth common species isolated from nosocomial infections in the USA and Switzerland.[2,5,6] Candida spp. comprise 96% of all opportunistic infections and is one among the top reasons for sepsis, accounting for 9% of the total pathogenic microbes.[7,8]
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