National Journal of Laboratory Medicine (Oct 2023)

Prevalence of Lower Respiratory Tract Fungal Infection at a Tertiary Care Hospital in Central Madhya Pradesh, India: A Cross-sectional Study

  • Bhavya Chiti,
  • Riti Jain Seth,
  • Kumkum Madoriya

DOI
https://doi.org/10.7860/NJLM/2023/64013.2784
Journal volume & issue
Vol. 12, no. 4
pp. MO09 – MO12 [30] Rafat Z, Hashemi SJ, Ashrafi K, Nikokar I, Jafari A, Rahimi Foroushani A, et al. Fungal isolates of the respiratory tract in symptomatic patients hospitalized in pulmonary units: A mycological and molecular epidemiologic study. J Multidiscip Healthc. 2020;13:661-69. [31] Zomorodian K, Rahimi MJ, Pakshir K, Motamedi M, Ghiasi MR, Rezashah H. Determination of antifungal susceptibility patterns among the clinical isolates of Candida species. J Glob Infect Dis. 2011;3(4):357-60. [32] Khadka S, Sherchand JB, Pokhrel BM, Parajuli K, Mishra SK, Sharma S, et al. Isolation, speciation and antifungal susceptibility testing of Candida isolates from various clinical specimens at a tertiary care hospital, Nepal. BMC Res Notes. 2017;10(1):218. [33] Perlin DS. Echinocand in resistance in Candida. Clin Infect Dis. 2015;61(Suppl 6):S612-17. [34] Ahir HR, Gohil BP. Prevalence of fungal infections in patients attending tertiary care teaching hospital, middle Gujarat, India. IJMR. 2020;5(3):364-67. PARTICULARS OF CONTRIBUTORS: 1. Junior Resident, Department of Microbiology, Netaji Subhash Chandra Bose Medical College, Jabalpur, Madhya Pradesh, India. 2. Professor and Head, Department of Microbiology, Netaji Subhash Chandra Bose Medical College, Jabalpur, Madhya Pradesh, India. 3. Assistant Professor, Department of Microbiology, Netaji Subhash Chandra Bose Medical College, Jabalpur, Madhya Pradesh, India. PLAGIARISM CHECKING METHODS: [Jain H et al.] • Plagiarism X-checker: Mar 21, 2023 • Manual Googling: Jun 10, 2023 • iThenticate Software: Sep 04, 2023 (15%) NAME, ADDRESS, E-MAIL ID OF THE CORRESPONDING AUTHOR: Etymology: Author Origin Dr. Riti Jain Seth, Professor and Head, Department of Microbiology, Netaji Subhash Chandra Bose Medical College, Jabalpur-482003, Madhya Pradesh, India. E-mail: [email protected] Date of Submission: Mar 14, 2023 Date of Peer Review: Apr 19, 2023 Date of Acceptance: Sep 05, 2023 Date of Publishing: Oct 01, 2023 Author declaration: • Financial or Other Competing Interests: None • Was Ethics Committee Approval obtained for this study? Yes • Was informed consent obtained from the subjects involved in the study? No • For any images presented appropriate consent has been obtained from the subjects. NA Emendations: 8

Abstract

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Introduction: The incidence of fungal infections and resistant isolates has risen exponentially due to multiple factors. This makes the isolation of fungi, performing identification, and susceptibility testing a necessary routine microbiological procedure. Assessing the burden and analysing the epidemiologic trends of fungal infections is critical for patient management. Aim: To determine the prevalence of various fungal infections affecting the lower respiratory tract. Materials and Methods: In this cross-sectional study conducted at Department of Microbiology, Netaji Subhash Chandra Bose (NSCB) Medical College Jabalpur, Madhya Pradesh, India specimens from 400 patients with suspected Lower Respiratory Tract Infection (LRTI) were processed following standard microbiological methods for fungal culture and sensitivity testing. All the fungal isolates were obtained and their antifungal susceptibility pattern were recorded. The data entry was done in a Microsoft Excel spreadsheet, and the final analysis was performed using the Statistical Package for Social Sciences (SPSS) software, version 25.0, developed by IBM in Chicago, USA. Results: The majority of the assessed specimens were sputum (285, 71.2%). Out of the 115 Candida isolates, C.albicans (61, 53%) was the most common species isolated. Among the Non-Candida albicans Candida (NCAC) group, C. tropicalis (32, 27.8%) was the predominant isolate, followed by C. glabrata (16, 13.9%) and C. krusei (6, 5.2%). C. albicans was found to be the most prevalent in the elderly population (>60 years of age), whereas NCAC was prevalent in the 46-60 years age group. Regarding the antifungal drug susceptibility pattern, significantly higher drug resistance was seen in the NCAC group compared to C. albicans towards agents such as ketoconazole, fluconazole, itraconazole, voriconazole, amphotericin-B, and nystatin. None of the fungal isolates demonstrated resistance to caspofungin. Conclusion: Fungal aetiology is a significant problem in patients with LRTI, which often remains underdiagnosed, increasing morbidity and mortality. Therefore, it should be kept in mind while managing a patient with LRTI.

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