Medical Journal of Dr. D.Y. Patil Vidyapeeth (Nov 2024)

Genomic Assessment of Resistance of Invasive Fungal Infections in Immunocompromised Patients

  • Dhanapal Nandini,
  • J Manonmoney,
  • P Subashini

DOI
https://doi.org/10.4103/mjdrdypu.mjdrdypu_894_23
Journal volume & issue
Vol. 17, no. 6
pp. 1225 – 1230

Abstract

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Introduction: Invasive fungal infections (IFIs) are emerging and significantly increased in immunocompromised populations. These infections are the most commonly acquired by inhalation of spores and can be transmitted by percutaneous inoculation in cutaneous and subcutaneous infections. Candida and Aspergillus species remain the most common cause of invasive fungal infections including neutropenia, hematological malignancies, bone marrow transplantation, parenteral nutrition prolonged treatment with corticosteroids, chemotherapy, HIV infection, invasive medical procedures, and the newer immune suppressive agents. Materials and Methods: An observational study was carried out at SRM MCH&RC, Tamil Nadu, India, in January 2020. Invasive fungal infections were identified in conventional methods (KOH, Gram staining, culture, sugar assimilation, sugar fermentation, LPCB). Antifungal susceptibility testing was done as per standard guidelines; the resistant species were subjected to molecular testing to identify the gene. Results: Clinical samples are collected from the various departments (blood, pus, tissues, BAL, pleural fluid, and other body fluids). Out of 110 clinical samples, 16 samples were positive for yeast infections and five were positive for moulds. Eighty-nine samples were negative for fungal infection. Among yeast isolates, Candida tropicalis (37%) was the most common in the study population, followed by C albicans (25%), C krusei (19%), C.glabrata (13%), and C.parapsilosis (6%). Among the filamentous fungi, all the isolates were present in the same prevalence. Some of the Candida spp. were found to be resistant to amphotericin B (2), fluconazole (2), and itraconazole (1). All moulds were found to be sensitive to the tested antifungals by microbroth dilution methods. Among the resistant Candida, spp.ERG11 gene was found to be common. Conclusion: We observed that the early detection of etiological agents by microscopy and culture and prompt initiation of antifungal therapy can aid in the reduction of morbidity and mortality among immunocompromised patients.

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