Study of Candida Bloodstream Infections in Surgical Intensive Care Unit Patients and Susceptibility Profile of the Isolates

Abstract

Background: The increased incidence of fungal infections in the past two decades has been overwhelming. Despite the fact that invasive fungal infections are still under-diagnosed and underreported, bloodstream infection due to Candida is now being recognized as an important public health problem especially in ICU patients with considerable morbidity, mortality and health care costs. Objective: To study the incidence, risk factors and antifungal susceptibility of Candida bloodstream infection in our hospital. Material and Methods: In the present study, the blood samples were collected from patients admitted in Surgical ICU. Samples were processed and antifungal susceptibility of the isolates was performed using standard protocol. Results: Out of total 93 patients, 14 (15.05%) were positive for candidemia with equal distribution of both C. albicans and nonalbicans Candida spp. The risk factors associated with candidemia showing statistical significance were length of ICU stay > 7 days, mechanical ventilation, central venous catheters and uncontrolled diabetes. Among the patients with candidemia the mortality rate was 78.57 %. Resistance to Amphotericin B was seen in 33.33 % isolates of C. tropicalis and 100 % isolates of C. rugosa. 33.33 % of C. tropicalis and 50 % of C. rugosa showed dose dependent susceptibility to Fluconazole. Conclusion: Early diagnosis and antifungal susceptibility testing is very important in the treatment of candidemia for reducing the mortality rate.

Keywords

• Antifungal Susceptibility Testing
• Candidemia
• Risk factors