Candiduria in catheterized intensive care unit patients : Emerging microbiological trends

Introduction: Hospital infections caused by Candida spp. are a leading cause of morbidity and mortality in hospitalized patients, particularly those that are critically ill or immunocompromised. In this study, the distributio n of Candida species in isolates from the University Hospital of the Federal University at Grande Dourados and their in vitro susceptibility to antifungal drugs were analyzed. Methods: Yeasts were phenotypically identifi ed using classical methodologies. Antifungal susceptibility tests to amphotericin B and fl uconazole were performed using the broth microdilution technique. Results: A total of 50 Candida isolates were obtained from hospitalized patients during the study period. We analyzed yeast isolates from urine (n=31; 62%), blood (n=12; 24%), and tracheal secretions (n=7; 14%). The following Candida species were identifi ed: C. tropicalis (n=21; 42%), C. albicans (n=18; 36%), C. glabrata (n=10; 20%), and C. krusei (n=1; 2%). Antifungal susceptibility tests demonstrated that C. albicans was susceptible to both antifungal agents. However, 31.2% of the non-C. albicans Candida isolates displayed dose-dependent susceptibility to fl uconazole, and 3.1% were resistant to amphotericin B. Conclusions: In contrast to previous reports, our results indicated that C. tropicalis was the most commonly isolated yeast species among the hospital patients. The predominance of non-C. albicans Candida infections confi rms the importance of species-level identifi cation for implementing appropriate antifungal therapies.

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“…Among urinary tract fungal infections, C. tropicalis is the second or third most frequently isolated Candida species in urine cultures 25,26 .…”

Section: Discussionmentioning

confidence: 99%

Antifungal susceptibility and distribution of Candida spp. isolates from the University Hospital in the municipality of Dourados, State of Mato Grosso do Sul, Brazil

Almeida

Shinobu-Mesquita

Svidzinski

et al. 2013

Rev. Soc. Bras. Med. Trop.

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“…[5][6][7][8][9][10][11] These studies are mainly from Delhi and there have been sporadic reports fro m Ko lkat a, Pune, Chandigarh and Dehradun. [5][6][7][8][9][10][11] There is an urgent need for surveillance studies on fungal infections and fungal colonizations from different health care institutions nation-wide to provide data on this subject. It is important to differentiate fungal infection from fungal colonizat ion as colonization may precede fungal infection, especially in the critical care setting.…”

Section: Original Articlementioning

confidence: 99%

Epidemiology of fungal infections in critical care setting of a tertiary care teaching hospital in North India: a prospective surveillance study

Singh¹,

Kashyap²,

Ahluwalia³

et al. 2014

JCSR

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Background: During recent years, fungal infections have risen exponentially and are a cause of significant morbidity and mortality in hospitalized patients, especially in the critical care setting. There is paucity of data from India on fungal pathogens. Methods:We prospectively studied patients admitted to medical and surgical critical care section of a tertiary care institute in northern India. The clinical samples of patients were processed in Department of Microbiology for isolation and identification of fungi by using standard protocols over a period of one year. The patients were categorized into fungal infection and colonization groups. The demographic data and risk factors for fungal infection and colonization were evaluated.Results: Ninety one (82.7%) of the 110 patients enrolled in the study, had fungal infection, whereas 19 (17.3%) had fungal colonization. Candida were isolated from 85/91 (93.4%) and 19/19 (100%) patients with fungal infection and colonization respectively. There was predominance of non-albicans Candida spp both in fungal infection 61/85 (71.7%) patients as well as fungal colonization group 16/19 (84.2% ). In non-albicans Candida spp., Candida tropicalis was the most common isolate observed in both fungal infection (85.3%) and fungal colonization (63.1%) groups. Overall, in patients with fungal infection, candiduria was detected in 68/91 (74.7%) whereas candidaemia was observed in 19/ 91 (20.8%) patients. The risk factors for fungal infections included urinary catheterization (85.7%), central line insertion (81.3%), mechanical ventilation (52.7%), use of corticosteroids (23.1%), total parentral nutrition (6.6%) and peritoneal dialysis (3.3%). Conclusions:The emergence of non-albicans Candida similar to the trends in the western countries should be a cause of concern in our country. Proper surveillance of fungal pathogens is important to improve quality of care in critical care setting and measures should be focussed to control these infections, especially in patients with these risk factors.

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“…Yoğun bakım ünitesinde kandidüri yüksek mortalite ile karakterizedir ve görülme sıklığı giderek artmaktadır. Üriner kateter varlığı, ileri yaş, diabet ve geniş spektrumlu antibiyotik kullanımı öyküsü kandidüri için risk faktörleri olarak bildirilmiştir (3,17). Kandidürilerde en sık izole edilen etken C.albicans'tır (3).…”

Section: Discussionunclassified

Investigation of Species Distribution and Antifungal Susceptibility of Candida Species Isolated from Various Clinical Samples From Intensive Care Unit Patients

Pelit¹,

Uzun²

2016

Yoğun Bakim Derg

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Candiduria in catheterized intensive care unit patients : Emerging microbiological trends

Cited by 57 publications

References 20 publications

Antifungal susceptibility and distribution of Candida spp. isolates from the University Hospital in the municipality of Dourados, State of Mato Grosso do Sul, Brazil

Antifungal susceptibility and distribution of Candida spp. isolates from the University Hospital in the municipality of Dourados, State of Mato Grosso do Sul, Brazil

Epidemiology of fungal infections in critical care setting of a tertiary care teaching hospital in North India: a prospective surveillance study

Investigation of Species Distribution and Antifungal Susceptibility of Candida Species Isolated from Various Clinical Samples From Intensive Care Unit Patients

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