ASSESSMENT OF SPECIATION AND ANTIFUNGAL SUSCEPTIBILITY TESTING IN THE INTENSIVE CARE UNIT: AN OBSERVATIONAL CROSS-SECTIONAL STUDY DESIGN.

Objectives:  This study aims to investigate the epidemiology of Candidemia in patients admitted to Intensive Care Units (ICUs), focusing on the distribution of species, antifungal susceptibility patterns, and demographic factors.  Methods:  The study was carried out for 1 year at the Departme...

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Main Authors: Bhuvan Shome, Ashok Kumar Sharma, Kumari Seema, Abhay Kumar, Manoj Kumar, Manju Boipai
Format: Article
Language:English
Published: Student's Journal of Health Research 2023-12-01
Series:Student's Journal of Health Research Africa
Subjects:
Online Access:https://sjhresearchafrica.org/index.php/public-html/article/view/867
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author Bhuvan Shome
Ashok Kumar Sharma
Kumari Seema
Abhay Kumar
Manoj Kumar
Manju Boipai
author_facet Bhuvan Shome
Ashok Kumar Sharma
Kumari Seema
Abhay Kumar
Manoj Kumar
Manju Boipai
author_sort Bhuvan Shome
collection DOAJ
description Objectives:  This study aims to investigate the epidemiology of Candidemia in patients admitted to Intensive Care Units (ICUs), focusing on the distribution of species, antifungal susceptibility patterns, and demographic factors.  Methods:  The study was carried out for 1 year at the Department of Microbiology, Rajendra Institute of Medical Sciences in Jharkhand, India, and collected 817 blood samples from ICU-admitted patients with signs of sepsis. Using various tests, including germ tube tests and MALDI-TOF mass spectrometry, the study identified Candida species and conducted antifungal susceptibility tests with the VITEK-2 system. The results, categorized as vulnerable, intermediate, or resistant, provided insights into the incidence rates and sensitivity of Candidemia in the studied population.  Results:  The study revealed a Candidemia incidence of 9.57 % among 292 positive blood cultures from ICU-admitted patients. Non-candida albicans predominated at 71.42 %, with Candida tropicalis species encompassing over 28.57 % of the cases. Antifungal susceptibility testing showed all species were vulnerable to the antifungals employed in this study, with C. krusei displaying innate resistance to fluconazole.  Conclusion:  This study highlights the changing epidemiology of Candidemia, with a notable rise in non-candida albicans species, especially in pediatric patients, particularly infants. Despite these shifts, the identified Candida isolates demonstrated overall susceptibility to tested antifungals, emphasizing the significance of precise species-level confirmation and antifungal vulnerability testing for tailored therapeutic approaches in the ICU setting.  Recommendation:  This study recommends continuous monitoring of local Candida species distribution, presumptive identification, and confirmation for early empirical therapy. Moreover, coupled with regular antifungal susceptibility testing to enhance treatment outcomes in vulnerable patient populations.
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spelling doaj.art-2346fe1119af4cd49e8bd5020c041d032023-12-15T08:34:23ZengStudent's Journal of Health ResearchStudent's Journal of Health Research Africa2709-99972023-12-0141210.51168/sjhrafrica.v4i12.867ASSESSMENT OF SPECIATION AND ANTIFUNGAL SUSCEPTIBILITY TESTING IN THE INTENSIVE CARE UNIT: AN OBSERVATIONAL CROSS-SECTIONAL STUDY DESIGN.Bhuvan Shome0Ashok Kumar Sharma1Kumari Seema2Abhay Kumar3Manoj Kumar4Manju Boipai5Senior Resident, Department of Microbiology, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India. Additional Professor, Department of Microbiology, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India.Assistant Professor, Department of Microbiology, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India.Assistant Professor, Department of Microbiology, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India.Professor, Department of Microbiology, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, IndiaAssistant Professor, Department of Microbiology, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India, Objectives:  This study aims to investigate the epidemiology of Candidemia in patients admitted to Intensive Care Units (ICUs), focusing on the distribution of species, antifungal susceptibility patterns, and demographic factors.  Methods:  The study was carried out for 1 year at the Department of Microbiology, Rajendra Institute of Medical Sciences in Jharkhand, India, and collected 817 blood samples from ICU-admitted patients with signs of sepsis. Using various tests, including germ tube tests and MALDI-TOF mass spectrometry, the study identified Candida species and conducted antifungal susceptibility tests with the VITEK-2 system. The results, categorized as vulnerable, intermediate, or resistant, provided insights into the incidence rates and sensitivity of Candidemia in the studied population.  Results:  The study revealed a Candidemia incidence of 9.57 % among 292 positive blood cultures from ICU-admitted patients. Non-candida albicans predominated at 71.42 %, with Candida tropicalis species encompassing over 28.57 % of the cases. Antifungal susceptibility testing showed all species were vulnerable to the antifungals employed in this study, with C. krusei displaying innate resistance to fluconazole.  Conclusion:  This study highlights the changing epidemiology of Candidemia, with a notable rise in non-candida albicans species, especially in pediatric patients, particularly infants. Despite these shifts, the identified Candida isolates demonstrated overall susceptibility to tested antifungals, emphasizing the significance of precise species-level confirmation and antifungal vulnerability testing for tailored therapeutic approaches in the ICU setting.  Recommendation:  This study recommends continuous monitoring of local Candida species distribution, presumptive identification, and confirmation for early empirical therapy. Moreover, coupled with regular antifungal susceptibility testing to enhance treatment outcomes in vulnerable patient populations. https://sjhresearchafrica.org/index.php/public-html/article/view/867CandidemiaNon-albicans CandidaICUAntifungal susceptibility
spellingShingle Bhuvan Shome
Ashok Kumar Sharma
Kumari Seema
Abhay Kumar
Manoj Kumar
Manju Boipai
ASSESSMENT OF SPECIATION AND ANTIFUNGAL SUSCEPTIBILITY TESTING IN THE INTENSIVE CARE UNIT: AN OBSERVATIONAL CROSS-SECTIONAL STUDY DESIGN.
Student's Journal of Health Research Africa
Candidemia
Non-albicans Candida
ICU
Antifungal susceptibility
title ASSESSMENT OF SPECIATION AND ANTIFUNGAL SUSCEPTIBILITY TESTING IN THE INTENSIVE CARE UNIT: AN OBSERVATIONAL CROSS-SECTIONAL STUDY DESIGN.
title_full ASSESSMENT OF SPECIATION AND ANTIFUNGAL SUSCEPTIBILITY TESTING IN THE INTENSIVE CARE UNIT: AN OBSERVATIONAL CROSS-SECTIONAL STUDY DESIGN.
title_fullStr ASSESSMENT OF SPECIATION AND ANTIFUNGAL SUSCEPTIBILITY TESTING IN THE INTENSIVE CARE UNIT: AN OBSERVATIONAL CROSS-SECTIONAL STUDY DESIGN.
title_full_unstemmed ASSESSMENT OF SPECIATION AND ANTIFUNGAL SUSCEPTIBILITY TESTING IN THE INTENSIVE CARE UNIT: AN OBSERVATIONAL CROSS-SECTIONAL STUDY DESIGN.
title_short ASSESSMENT OF SPECIATION AND ANTIFUNGAL SUSCEPTIBILITY TESTING IN THE INTENSIVE CARE UNIT: AN OBSERVATIONAL CROSS-SECTIONAL STUDY DESIGN.
title_sort assessment of speciation and antifungal susceptibility testing in the intensive care unit an observational cross sectional study design
topic Candidemia
Non-albicans Candida
ICU
Antifungal susceptibility
url https://sjhresearchafrica.org/index.php/public-html/article/view/867
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