Pattern of bacterial and fungal pathogen in patients with high risk for invasive fungal disease in an indonesian tertiary care hospital: an observational study.

Gurmeet Singh,Stephanie Gita Wulansari

doi:10.11604/pamj.2018.29.60.11931

Abstract

IntroductionIn critically ill patients, there is a defect in host defense mechanism resulting in increased susceptibility to bacterial and fungal infection. The pattern of organisms causing infections varies between different countries and hospitals; therefore it is important that every hospital generates antibiograms to guide healthcare professionals during treatment with optimal choice of antibiotics. Our study aimed to described the pattern of fungal and bacterial pathogen in patients with high risk for invasive fungal disease (IFD).MethodsAn observational study was conducted in Cipto Mangunkusumo Hospital, Jakarta, Indonesia, within March-September 2015. Specimens were taken from blood, sputum, endotracheal aspiration, bronchoalveolar lavage (BAL), urine, pus and drainage fluid/surgical tissue specimen on 5th-7th day of hospitalization. Samples were cultured onto suitable culture media and bacterial isolates were identified using standard biochemical methods.ResultsBacteria and Candida sp. were isolated from 153 patients. C. tropicalis (44.31%) was the commonest fungal isolated. Incidence of gram-negative bacteria was higher than gram-positive bacteria. Klebsiella pneumonia was the most common gram-negative bacteria isolated, where as Enterococcus faecalis for gram-positive bacteria.ConclusionCritically ill patients were vulnerable to contracted fungal and bacterial pathogen. Candida non-albicans and Gram-negative bacteria were the most common pathogen detected among critically ill patients with high risk for IFD.

Highlights

Invasive fungal disease (IFD) is a major cause of morbidity and mortality in the critically ill and imunocompromised patients, most commonly caused by Candida sp [1,2,3,4]
We found Enterococcus faecalis (N = 7, 16.28%), Klebsiella pneumoniae (N = 33, 25.78%) and Candida tropicalis (N = 39, 44.31%) as the most common
We describe the bacterial and fungal pathogens found in critically ill patients with high risk for invasive fungal disease

Summary

Introduction

Invasive fungal disease (IFD) is a major cause of morbidity and mortality in the critically ill and imunocompromised patients, most commonly caused by Candida sp [1,2,3,4]. Ill patients are susceptible to fungal infection and bacterial and opportunistic infections. There is a defect in the host defense mechanisms due to immunesuppressive effects of the underlying diseases, recent surgery, trauma and concurrent drug therapy, which results in increased susceptibility to infections. The main objective of this study is to determine the pathogen profile in critically ill patients with high risk of invasive fungal disease in an Indonesian tertiary care hospital. Better understanding of pathological pattern can help determine appropriate antibiotic and antifungal administration especially in critically ill patients in order to decrease the morbidity and mortality

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Conclusion