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An observational study on the epidemiological and mycological profile of Candidemia in ICU patients.

Kotwal A, Biswas D, Sharma JP, Gupta A, Jindal P - Med. Sci. Monit. (2011)

Bottom Line: Forty-one of the recruited patients (45%) were found to be candidemic, with the majority of patients being in the extremes of age (13 neonates and 15 >65 years of age).Four risk factors were found to be significantly associated with the occurrence of candidemia in our patients - a period of hospitalization exceeding 7 days (p=0.0008), previous use of antibiotics (p=0.001), presence of chronic renal failure (p=0.003), and ongoing cancer chemotherapy (p= 0.041).Fluconazole resistance was observed among 26% of all Candida isolates and 17.3% of C. albicans isolates.

View Article: PubMed Central - PubMed

Affiliation: Department of Microbiology, Himalayan Institute of Medical Sciences, Swami Ram Nagar, Jolly Grant, Dehradun, India.

ABSTRACT

Background: This study aimed to analyze the epidemiological and mycological profile of candidemia in intensive care unit (ICU) patients attending a tertiary care teaching hospital in the Himalayan region of northern India.

Material/methods: A 15-bed medico-surgical ICU and a 5-bed pediatric ICU. Ninety-one consecutively admitted ICU patients were screened for the presence of candidemia by performing blood cultures at periodic intervals.

Results: The recovered Candida isolates were speciated and subjected to antifungal susceptibility testing using standard procedures. Forty-one of the recruited patients (45%) were found to be candidemic, with the majority of patients being in the extremes of age (13 neonates and 15 >65 years of age). Four risk factors were found to be significantly associated with the occurrence of candidemia in our patients - a period of hospitalization exceeding 7 days (p=0.0008), previous use of antibiotics (p=0.001), presence of chronic renal failure (p=0.003), and ongoing cancer chemotherapy (p= 0.041). Ninety-six Candida isolates were recovered from the 41 culture-positive patients, with Candida albicans being the commonest isolate recovered (n=75, 78.1%), followed by Candida tropicalis (n=15, 16%), and Candida glabrata (n=6, 6.5%). Fluconazole resistance was observed among 26% of all Candida isolates and 17.3% of C. albicans isolates.

Conclusions: Contrary to the majority of recent reports, species shift towards non-albicans candidemia has not been observed in our center, though the prevalence of azole resistance is alarmingly high even among the C. albicans isolates.

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Time kinetics of recovery of Candida isolates.
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f1-medscimonit-17-11-cr663: Time kinetics of recovery of Candida isolates.

Mentions: Ninety-six Candida isolates were recovered from the 41 culture-positive patients. The proportion of candidemic patients increased significantly beyond the 7th day of ICU stay (p= 0.0002). The maximum number of Candida isolates was recovered between the 8th to 10th days of ICU stay (Figure 1). Thirty-one (75.6%) of the candidemic patients yielded multiple culture-positive samples. Candida albicans was the commonest isolate recovered (n=75, 78.1%), followed by Candida tropicalis (n=15, 16%) and Candida glabrata (n=6, 6.5%). Multiple Candida species were not recovered from any patient. We next analyzed whether the distribution of risk factors was different between patients infected with C. albicans and those with non-albicans species. No statistically significant difference was observed between the 2 groups in terms of age, sex, length of hospitalization, administration of antibiotics or immunosuppressive agents, presence of indwelling devices and co-existence of the majority of co-morbid conditions and risk factors.


An observational study on the epidemiological and mycological profile of Candidemia in ICU patients.

Kotwal A, Biswas D, Sharma JP, Gupta A, Jindal P - Med. Sci. Monit. (2011)

Time kinetics of recovery of Candida isolates.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3539502&req=5

f1-medscimonit-17-11-cr663: Time kinetics of recovery of Candida isolates.
Mentions: Ninety-six Candida isolates were recovered from the 41 culture-positive patients. The proportion of candidemic patients increased significantly beyond the 7th day of ICU stay (p= 0.0002). The maximum number of Candida isolates was recovered between the 8th to 10th days of ICU stay (Figure 1). Thirty-one (75.6%) of the candidemic patients yielded multiple culture-positive samples. Candida albicans was the commonest isolate recovered (n=75, 78.1%), followed by Candida tropicalis (n=15, 16%) and Candida glabrata (n=6, 6.5%). Multiple Candida species were not recovered from any patient. We next analyzed whether the distribution of risk factors was different between patients infected with C. albicans and those with non-albicans species. No statistically significant difference was observed between the 2 groups in terms of age, sex, length of hospitalization, administration of antibiotics or immunosuppressive agents, presence of indwelling devices and co-existence of the majority of co-morbid conditions and risk factors.

Bottom Line: Forty-one of the recruited patients (45%) were found to be candidemic, with the majority of patients being in the extremes of age (13 neonates and 15 >65 years of age).Four risk factors were found to be significantly associated with the occurrence of candidemia in our patients - a period of hospitalization exceeding 7 days (p=0.0008), previous use of antibiotics (p=0.001), presence of chronic renal failure (p=0.003), and ongoing cancer chemotherapy (p= 0.041).Fluconazole resistance was observed among 26% of all Candida isolates and 17.3% of C. albicans isolates.

View Article: PubMed Central - PubMed

Affiliation: Department of Microbiology, Himalayan Institute of Medical Sciences, Swami Ram Nagar, Jolly Grant, Dehradun, India.

ABSTRACT

Background: This study aimed to analyze the epidemiological and mycological profile of candidemia in intensive care unit (ICU) patients attending a tertiary care teaching hospital in the Himalayan region of northern India.

Material/methods: A 15-bed medico-surgical ICU and a 5-bed pediatric ICU. Ninety-one consecutively admitted ICU patients were screened for the presence of candidemia by performing blood cultures at periodic intervals.

Results: The recovered Candida isolates were speciated and subjected to antifungal susceptibility testing using standard procedures. Forty-one of the recruited patients (45%) were found to be candidemic, with the majority of patients being in the extremes of age (13 neonates and 15 >65 years of age). Four risk factors were found to be significantly associated with the occurrence of candidemia in our patients - a period of hospitalization exceeding 7 days (p=0.0008), previous use of antibiotics (p=0.001), presence of chronic renal failure (p=0.003), and ongoing cancer chemotherapy (p= 0.041). Ninety-six Candida isolates were recovered from the 41 culture-positive patients, with Candida albicans being the commonest isolate recovered (n=75, 78.1%), followed by Candida tropicalis (n=15, 16%), and Candida glabrata (n=6, 6.5%). Fluconazole resistance was observed among 26% of all Candida isolates and 17.3% of C. albicans isolates.

Conclusions: Contrary to the majority of recent reports, species shift towards non-albicans candidemia has not been observed in our center, though the prevalence of azole resistance is alarmingly high even among the C. albicans isolates.

Show MeSH
Related in: MedlinePlus