scholarly journals Epidemiology of Candida blood stream infections: experience of a tertiary care centre in North India

2013 ◽  
Vol 7 (09) ◽  
pp. 670-675 ◽  
Author(s):  
Jagdish Chander ◽  
Nidhi Singla ◽  
Shailpreet Kaur Sidhu ◽  
Satinder Gombar
Keyword(s):  
Risk Factors ◽  
Amphotericin B ◽  
Candida Species ◽  
Antifungal Susceptibility ◽  
Tertiary Care ◽  
Bloodstream Infections ◽  
Blood Stream ◽  
North India ◽  
Tertiary Care Centre ◽  
Candida Spp

Introduction: Bloodstream infections due to Candida species are becoming a major cause of morbidity and mortality in hospitalized patients. The spectrum of candidemia has changed with the emergence of non-albicans Candida species, especially among critically ill patients. Methodology: In a retrospective study (July 2009 to December 2009) on candidemia, various Candida species isolated from blood cultures were characterized and studied along with the determination of their antifungal susceptibility to amphotericin B, itraconazole, and fluconazole by Etest. Probable risk factors for patients in the intensive care unit (ICU) presenting with candidemia were also analyzed. Results: During the study period, a total of 4651 samples were received, out of which 468 samples (10.06%) were positive for growth of organisms: 441 (94.20%) aerobic bacterial pathogens and 27 (5.79%) Candida species. The most common Candida spp. isolate was C. tropicalis (40.8%) followed by C. albicans (29.6%), C. glabrata (18.5%) and others (11.1%). Out of the 27 Candida strains, 24 (88.9%) were isolated from patients treated in the ICU. Among these, association of previous use of broad-spectrum antibiotics in 22 patients (91.6%) and central line catheter insertion in 20 patients (83.3%) were found to be statistically significant as compared to non-candidemia patients (p <0.05). Antifungal susceptibility testing of the isolates revealed a lower level of drug resistance to amphotericin B (18.5% of the isolates) versus 77.8% resistance to fluconazole. Conclusion: Rapid changes in the rate of infection, potential risk factors, and emergence of non-albicans Candida demand continued surveillance of this serious bloodstream fungal infection.

scholarly journals Characteristics and clinical outcomes of patients with Candida bloodstream infections in a tertiary care hospital in Jordan

2017 ◽  
Vol 11 (11) ◽  
pp. 861-867 ◽  
Author(s):  
Mera Ababneh ◽  
Ola Ali Abu-Bdair ◽  
Nizar Mhaidat ◽  
Basima Abdalla Almomani
Keyword(s):  
Risk Factors ◽  
Candida Species ◽  
Tertiary Care ◽  
Bloodstream Infections ◽  
Blood Stream ◽  
Tertiary Hospital ◽  
Care Hospital ◽  
Factors Associated ◽  
Surveillance Programs ◽  
Sepsis And Septic Shock

Introduction: Candida species are important causes of bloodstream infections, accounting for significant morbidity and mortality in hospitalized patients. Methodology: A retrospective observational study was conducted in an academic tertiary hospital of Jordan. The medical records of patients hospitalized over a ten-year period. were reviewed and patients with candidemia were identified. Data analysis included the infecting Candida species, resistance to antifungals, and risk factors associated with mortality. Results: A total of 158 cases of candidemia were identified, with an overall incidence rate of 0.48 episodes/1,000 admissions. The proportion of candidemia caused by Candida albicans (44.3%) was higher than that of candidemia caused by non-albicans Candida species (42.4%). Exposure to antibiotic therapy before hospitalization was the only independent factor associated with non-albicans Candida infection (OR 2.454; p = 0.033). The overall crude 30-day mortality was 38.7%. Central venous catheterization (OR 0.255; p = 0.026), mechanical ventilation (OR 0.162; p = 0.003), severe sepsis and septic shock (OR = 0.073; p = 0.008), admission to intensive care unit (OR 0.78; p = 0.001), C. albicans (OR 0.235; p = 0.018), length of stay (OR 1.057; p = 0.001), number of comorbidities (OR 0.580; p = 0.008) were independent risk factors for 30-day mortality. Conclusion: This study identified several risk factors associated with blood stream infections caused by Candida over 10-years period. Continuous surveillance programs to monitor such types of infection are of great value to antimicrobial stewardship programs.

scholarly journals Evaluation of Specific Risk Factors and Outcomes of Colistin-Resistant Klebsiella pneumoniae Infections in a Tertiary Care Centre - An Observational Study

2021 ◽  
Vol 4 (2) ◽  
pp. 1-6
Author(s):  
Prakash Shastri ◽  
Shamanth A Shankarnarayan
Keyword(s):  
Risk Factors ◽  
Blood Stream Infection ◽  
Tertiary Care ◽  
Venous Catheter ◽  
Blood Stream ◽  
Central Line ◽  
Multidrug Resistant ◽  
Automated System ◽  
Tertiary Care Centre ◽  
Broth Microdilution Method

Background: Incidence of multidrug resistant Klebsiella pnumoniae infections are increasing globally especially in ICUs. Aim: We evaluated the burden of colistin resistant K. pneumoniae (ColR KP) and the risk factors associated with the outcome of these patients. Methods: Consecutive patients developing K. pneumoniae infections were included. K. pneumoniae from endotracheal tube and catheterized urine sample, having cell count <105 cfu/ml, and which did not necessitate a change in antibiotics as per the treating physicians was considered as colonizer. Demographic and clinical details were collected and samples were processed as per standard protocol. Any growth was identified and its antimicrobial susceptibility was carried out by using Vitek 2 automated system. Minimum inhibitory concentration of >4 μg/ml for Colistin was considered as resistant. The resistant isolates were confirmed with Broth microdilution method. Risk factor associated with the outcome of ColR KP was analyzed. Findings: Burden of K. pneumoniae infection was 50.02 per 1000 admissions. K. pneumonie (n=155) was isolated from patients with ventilator associated pneumonia (84, 54.2%), followed by blood stream infection (49, 31.6%) and urinary tract infection (22, 14.2%). ColR KP and intermediate (ColI KP) isolates were 58 (37.41%) and 97 (62.6%) respectively. Among ColR KP infected patients 32 (55.1%) died whereas 26 (44.8%) patients were discharged. Higher mortality was witnessed in ColI KP cases (75, 77.3%) compared to ColR-KP cases (32, 55.1%) (p=0.004; OR=2.77; 95% CI=1.37 to 5.59). Colistin resistance and presence of central line were independently associated with mortality. Conclusion: Colistin resistant K. pneumoniae infections among ICU patients are on rise. Presence of central venous catheter and resistance to colistin were independent predictors of mortality.

scholarly journals Surveillance of Candida spp Bloodstream Infections: Epidemiological Trends and Risk Factors of Death in Two Mexican Tertiary Care Hospitals

PLoS ONE ◽  
2014 ◽  
Vol 9 (5) ◽  
pp. e97325 ◽  
Author(s):  
Dora E. Corzo-Leon ◽  
Tito Alvarado-Matute ◽  
Arnaldo L. Colombo ◽  
Patricia Cornejo-Juarez ◽  
Jorge Cortes ◽  
...  
Keyword(s):  
Risk Factors ◽  
Tertiary Care ◽  
Bloodstream Infections ◽  
Candida Spp ◽  
Epidemiological Trends ◽  
Tertiary Care Hospitals

scholarly journals Surveillance and characterization of Candida bloodstream infections in a Serbian tertiary care hospital

2016 ◽  
Vol 10 (06) ◽  
pp. 643-656 ◽  
Author(s):  
Predrag Stojanovic ◽  
Nikola Stojanovic ◽  
Zorica Stojanovic-Radic ◽  
Valentina Arsić Arsenijević ◽  
Suzana Otasevic ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Antifungal Susceptibility ◽  
Tertiary Care ◽  
Bloodstream Infections ◽  
Drug Susceptibility ◽  
Antifungal Drugs ◽  
Care Hospital ◽  
Candida Spp ◽  
Multivariate Statistical ◽  
Medical Histories

Introduction: Candida spp. frequently cause hospital-acquired bloodstream infections (BSI) with a high mortality rate (up to 70%). We analyzed the frequency, infection characteristics, potential predisposing factors, susceptibility to antifungal drugs, biofilm production and other virulence characteristics of Candida spp. isolates obtained from a tertiary care hospital in Niš, Serbia, during a one year period. Methods: Medical histories, characteristics of isolated strains and drug susceptibility, as well as the effect on the function of isolated macrophages and other virulence features were evaluated. The obtained results were subjected to student’s t-test and multivariate statistical analyzes. Results: Herein we report an annual incidence of 3.65 cases of C. albicans, C. lusitaniae and C. lipolytica infections per 105 population. Out of eight isolated strains, two (25%) were shown to be strong biofilm producers, one (12.5%) caused hemolysis on blood agar and in two (25%) cases macrophages were able to completely eliminate the yeast colonies. Chronic kidney disease, diabetes, malignant and other diseases were present in 37.5, 62.5, 50 and 75%, respectively, in the study group. All patients with Candida BSI received antifungal therapy (amphotericin B), however, hospital mortality was observed in 25% of patients. Conclusions: Evaluation of local Candida epidemiology, antifungal susceptibility and virulence factors, as well as personalized patient risk factors are important for the surveillance of Candida BSI, especially in intensive care unit patients and may contribute to the improved options and outcome for patients with Candida BSI.

scholarly journals Candidemia in neonatal intensive care unit: a cause of concern

2017 ◽  
Vol 5 (5) ◽  
pp. 2165 ◽  
Author(s):  
Sarita Yadav ◽  
Shalley Dahiya ◽  
Diksha Budhani
Keyword(s):  
Candida Species ◽  
Neonatal Intensive Care ◽  
Very Low Birth Weight ◽  
Late Onset ◽  
Antifungal Susceptibility ◽  
Tertiary Care ◽  
Brain Heart Infusion ◽  
Candida Spp ◽  
Late Onset Sepsis ◽  
Sensitivity Pattern

Background: Candidemia in neonates is a serious and common cause of late onset sepsis. Candida species are the third most frequent organism isolated in late onset sepsis in very low birth weight (VLBW) infants (i.e., <1,500 g). Methods: This study was performed to evaluate epidemiology, species distribution, antifungal susceptibility and outcome of candida blood stream infections at a tertiary care centre.Results: About 1-2 ml of blood was collected aseptically in suspected cases of septicaemia and inoculated in 20 ml of Brain Heart Infusion(BHI) broth. Candida species isolates were confirmed by germ tube production, chlamydospore formation on corn meal agar(HiMedia), pigmentation on Hichrome Candida differential agar (Himedia), and carbohydrate assimilation tests. Non-albicans candida spp. are of special concern, due to their high virulence and low azole susceptibility characteristics, augmenting the high mortality rates.Conclusions: The emergence on non-albicans Candida merits attention as they display higher degree of resistance to azoles and are associated with higher mortality rates. Additional studies are required to define more accurately the prevalence and sensitivity pattern of Candida spp. which may serve as a template for development of preventive and therapeutic strategies for neonatal candidemia especially at peripheral health centres.

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