Candida utilis: a rare cause of septicemia in children

Candida utilis is an emerging fungal pathogen in blood. The main aim of this study was to describe the prevalence, methods of speciation and antifungal susceptibility of Candida utilis at a tertiary care centre. Methods. This was a retrospective study carried out at a tertiary care centre in South India. Over a period of 1 year, three Candida utilis were isolated from blood culture identified by MALDI–TOF MS Version 3.2 and were confirmed by ITS sequencing. Susceptibility testing was carried out by micro broth dilution. Results. All three patients had a common risk factor of prolonged ICU stay but the source of infection could not be identified. Candida utilis isolates were identified by MALDI–TOF and confirmed by ITS sequencing. They were pansusceptible to all tested antifungal drugs. Among these, two patients who were treated in hospital had good clinical outcome and response to antifungal drugs. A third patient was lost to follow up. Conclusion. Candida utilis was predominantly seen between 0–3 month olds. Conventional methods of speciation were unable to identify C. utilis to species level. Rapid identification was done by MALDI–TOF MS and confirmed by sequencing. Rapid identification leads to prompt treatment and favours a good clinical outcome.

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Intrastromal Injection of Voriconazole in the Treatment of Deep Fungal Keratitis - A Prospective Study in a Tertiary Care Centre in South India

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/285 ◽

2021 ◽

Vol 8 (20) ◽

pp. 1505-1509

Author(s):

Bindu Madhavi R ◽

Manjula Y.M ◽

Suma C ◽

Soumya Basanth ◽

Nibedita Acharya

Keyword(s):

Topical Treatment ◽

South India ◽

Tertiary Care ◽

Fungal Keratitis ◽

Antifungal Drugs ◽

Care Centre ◽

Mycotic Keratitis ◽

Tertiary Care Centre ◽

Case Series Study ◽

Intrastromal Injection

BACKGROUND Treatment of fungal ulcers is one of the most challenging tasks. Various topical antifungal drugs have poor corneal stromal penetration. Voriconazole is a broad spectrum drug and is an effective agent for the treatment of fungal keratitis as a topical preparation. It is potent against a broad range of clinically significant fungal infections both in the eye as well systemically. In tropical climatic conditions filamentous fungi commonly cause eye infections and are associated with poor visual outcomes. The treatment options for mycotic ulcers are limited, therefore direct intrastromal injections are helpful in the management of these deep mycotic keratitis. We wanted to evaluate the role of intrastromal injection of voriconazole in the management of deep fungal keratitis not responding to conventional therapy. METHODS This an interventional case series study done at a tertiary care centre in south India from the year April 2019 to August 2020. Eight eyes of eight patients with microbiologically proven deep stromal recalcitrant mycotic keratitis not responding to topical antifungal medications were evaluated. Voriconazole 50 microgram / 0.1 ml was injected around the infiltrate in the corneal stroma as an adjunctive to the topical antifungal treatment. Main outcome measure was a reduction of the size of the infiltrate and ulcer and decrease in infection on regular follow ups. RESULTS Before injecting voriconazole, all the cases were of either gradually worsening of lesions on topical treatment, or not responding to topical treatment. After the injection a rapid decrease in the size of corneal ulcer, hypopyon, and infiltration was seen within 3 weeks. CONCLUSIONS Targeted delivery of intrastromal voriconazole may be a safe and effective way in the management of deep seated fungal ulcers which respond poorly to conventional treatment procedures, thus reducing the need for further surgical treatment. KEYWORDS Intrastromal Injection, Voriconazole, Fungal Keratitis, Deep Mycotic Keratitis

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Abstract #1100: Tumor Induced Osteomalacia: Clinical; Biochemical and Radiological Features from a Single Tertiary Care Centre with Emphasis on Functional Imaging.

Endocrine Practice ◽

10.1016/s1530-891x(20)44225-9 ◽

2017 ◽

Vol 23 ◽

pp. 289

Author(s):

Vineet Surana ◽

Rajesh Khadgawat ◽

Nikhil Tandon ◽

Chandrashekhar Bal ◽

Kandasamy Devasenathipathy

Keyword(s):

Functional Imaging ◽

Tertiary Care ◽

Care Centre ◽

Tertiary Care Centre ◽

Radiological Features

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Emerging Antimicrobial Resistance Among Methicillin Resistant Staphylococcus Aureus (MRSA) in a Tertiary Care Centre in North India

JMS SKIMS ◽

10.33883/jms.v23i1.747 ◽

2020 ◽

Vol 23 (1) ◽

pp. 48-49

Author(s):

Javaid Ahmad Bhat ◽

Shariq Rashid Masoodi

Keyword(s):

Staphylococcus Aureus ◽

Antimicrobial Resistance ◽

Tertiary Care ◽

Resistance Mechanisms ◽

North India ◽

Global Public Health ◽

Care Centre ◽

Tertiary Care Centre ◽

Effective Prevention ◽

Mupirocin Resistance

Apropos to the article by Dr Bali, titled “Mupirocin resistance in clinical isolates of methicillin-sensitive and resistant Staphylococcus aureus in a tertiary care centre of North India” (1), the authors have raised important issue of emerging antimicrobial resistance (AMR). Antimicrobial resistance is an increasingly serious threat to global public health that requires action across all government sectors and society. As per WHO, AMR lurks the effective prevention and management of an ever-increasing spectrum of infections caused by bacteria, parasites, fungi and viruses. Novel resistance mechanisms are emerging and spreading globally, threatening the man’s ability to treat common infectious diseases.

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