Incidence, Risk Factors and Susceptibility Prole of Candida species Isolated from Blood of Non-Neutropenic Medical Intensive Care Unit Patients in a Tertiary Care Centre

Abstract

Background: The critically ill patients are particularly susceptible to rapid colonization by endemic pathogens or hospital ora. Both immunocompetent and immunocompromised patients are particularly exposed to various risk factors. Bloodstream infection due to Candida species is now recognized as an important public health problem especially in intensive care unit patients with considerable morbidity, mortality and health care costs. Aim: The aim was to study the incidence, risk factors and antifungal susceptibility of the Candida species isolated from blood of Medical Intensive Care Unit (MICU) patients in our hospital. Material and Methods: The blood samples collected from MICU patients were processed as per standard protocol and antifungal susceptibility testing was done by broth microdilution method. Results: Out of total 111 samples, 22 (19.81%) yielded Candida species of which non-albicans Candida species predominated. In MICU, the risk factors associated with candidemia showing statistical signicance were length of intensive care unitstay > 7 days, use of steroids, mechanical ventilation, central venous catheters and uncontrolled diabetes mellitus. C. albicans, C. parapsilosis and C. guillermondii have showed 100% susceptibility to Amphotericin B, 5-Flurocytosine, Fluconazole, Itraconazole and Voriconazole. C. krusei showed 100% resistance to uconazole. C. glabrata showed 100% resistance to Itraconazole and Voriconazole. The mortality rate among MICU patients with candidemia was 59.09%. Conclusion: Although the patients in the ICU are at risk for candidemia, rapid diagnosis of aetiologic agent will reduce the delay in initiating the appropriate therapy with adequate dosage of anti-fungal agents along with effective correction of underlying risk factors which may actually improve their outcome

Keywords

• Candidemia
• Medical Intensive Care Unit
• Broth Microdilution Method