Abstract
ABSTRACTContextTime to detection (TTD) given by continuous monitoring automated blood culture systems (CMABS) have been found to be a predictor of clinical outcome, drug resistance and type of microorganism in cases of bacteremia but the studies evaluating TTD with respect to fungemia are scarce especially from India.AimsTo evaluate TTD for yeast isolates in fungal bloodstream infections with respect to the type of yeast isolates, risk factors and outcome and to study yeast susceptibility and distribution of yeast isolates with respect to patient population.Materials and methodsAll blood culture specimens were processed in CMABS. The TTD for yeast isolates were recorded. The identification of yeast and susceptibility testing was done by automated methods. A correlation of TTD was done with respect to prior/concurrent yeast isolates, use of antifungal, risk factors and clinical outcome.ResultsOut of 80 yeast isolates, the maximum was C. parapsilosis (26.25%) followed by C. albicans (16.25%) and C. tropicalis (13.75%). A statistically significant difference in the occurrence of yeasts with early TTD (TTD < = 48 hours) and late TTD (TTD > 48 hours) was found. TTD of C. glabrata was significantly longer (p = 0.002) while TTD of C. tropicalis was significantly shorter (p = 0.013). There was an observable favorable outcome in shorter TTD (< = 48 hours). C. albicans and C. tropicalis depicted 100% susceptibility for Azoles, Amphotericin B and Echinocandins.ConclusionTTD may be used as both diagnostic and prognostic adjunct in fungal bloodstream infections. This study is a step towards this novel approach. We also emphasize on the importance of speciation of yeast isolates and susceptibility testing.How to cite this articleButta H, Sardana R, Mendiratta L, Sibal A, Gupta V, Chawla R, Jafri AA. Time to Detection of Yeast Isolates in Pediatric and Adult Patients with Fungemia and its Relevance to Clinical Profile and Outcome. Indian Journal of Critical Care Medicine, January 2019;23(1):27-30.
Highlights
The most common cause of systemic fungal infections in human beings is Candida and worldwide Candida bloodstream infections are showing a rising trend in recent years
We emphasize on the importance of speciation of yeast isolates and susceptibility testing
There are very few studies which evaluate Time to detection (TTD) with respect to Candidemia. Keeping this in mind, the present study was planned to isolate yeast from the blood cultures of the patients with suspected bloodstream infections, to record TTD of the blood culture positivity in patients with yeast isolates, to compare the TTD of different Candida species, to assess the impact of TTD on clinical outcome, to assess the risk factors associated with these yeast isolates and to study the antifungal susceptibility of these yeast isolates
Summary
The most common cause of systemic fungal infections in human beings is Candida and worldwide Candida bloodstream infections are showing a rising trend in recent years. Apart from advantages of CMABS like selfcontained modular incubation, agitation, self-monitoring of microbial growth with no need of manual manipulation of blood culture bottles the other usefulness is TTD given by the equipment when the blood culture positivity is indicated. There are very few studies which evaluate TTD with respect to Candidemia Keeping this in mind, the present study was planned to isolate yeast from the blood cultures of the patients with suspected bloodstream infections, to record TTD of the blood culture positivity in patients with yeast isolates, to compare the TTD of different Candida species, to assess the impact of TTD on clinical outcome, to assess the risk factors associated with these yeast isolates and to study the antifungal susceptibility of these yeast isolates
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