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


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.
Department of Microbiology, Himalayan Institute of Medical Sciences, Swami Ram Nagar, Jolly Grant, Dehradun, India.
Aarti
A
Kotwal
Debasis
D
Biswas
Jagdish Prasad
JP
Sharma
Alpa
A
Gupta
Parul
P
Jindal
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000009:adverse effects; D002175:Candida / Q000302:isolation & purification*; D058387:Candidemia / Q000453:epidemiology* / Q000209:etiology* / Q000382:microbiology*; D002648:Child; D002675:Child, Preschool; D025141:Drug Resistance, Fungal; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D015725:Fluconazole; D006801:Humans; D007194:India / Q000453:epidemiology; D007231:Infant, Newborn; D007362:Intensive Care Units; D007676:Kidney Failure, Chronic / Q000150:complications / Q000453:epidemiology; D008297:Male; D012307:Risk Factors; D013045:Species Specificity
D000900:Anti-Bacterial Agents; D015725:Fluconazole