Changing pattern of antifungal drug resistance in a tertiary health-care facility – A cross-sectional study

Background: Fungal infections remain a major source of morbidity and mortality, but treatment choices are restricted due to limited classes of antifungal agents. The emergence of antifungal drug resistance (AFDR) is a major concern. Understanding trend in the development of AFDR will facilitate the...

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Main Authors: Satabdi Sahu, Abinash Panda, Suryasnata Dash, Y Roja Ramani, Jayanti Prava Behera
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2023-01-01
Series:Current Medical Issues
Subjects:
Online Access:http://www.cmijournal.org/article.asp?issn=0973-4651;year=2023;volume=21;issue=4;spage=208;epage=213;aulast=Sahu
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author Satabdi Sahu
Abinash Panda
Suryasnata Dash
Y Roja Ramani
Jayanti Prava Behera
author_facet Satabdi Sahu
Abinash Panda
Suryasnata Dash
Y Roja Ramani
Jayanti Prava Behera
author_sort Satabdi Sahu
collection DOAJ
description Background: Fungal infections remain a major source of morbidity and mortality, but treatment choices are restricted due to limited classes of antifungal agents. The emergence of antifungal drug resistance (AFDR) is a major concern. Understanding trend in the development of AFDR will facilitate the use of therapeutic strategies to overcome and prevent antifungal resistance. The primary objective of the present study was to find out the pattern of AFDR in laboratory-confirmed mycological culture isolates. Methodology: The record-based cross-sectional study was carried out to analyze all the mycological culture sensitivity reports during a period of 3 years. The data set included clinicodemographic parameters such as age, gender, provisional diagnosis, type of culture specimens, identified fungal isolate, and susceptibility pattern. The association between the selected parameters and the pattern of AFDR was found out by Pearson's Chi-squared test. Results: AFDR among the isolates was 22 (75.86%), 8 (61.54%), 25 (100%), and 7 (70%) during the period from 2019 to 2022. The rate of AFDR was 33.87% during the study period. Antifungal susceptibility testing showed a rising trend in fluconazole resistance from 2019 (27.2%) to 2022 (57.1%). AFDR was highest in the age group of 41–60 years (48.3%), in males (72.5%), in skin scrapings (40.3%), and in cases with a provisional diagnosis of deep mycosis (51.6% in deep mycosis vs. 46.7% in superficial mycosis). The association between age, type of clinical specimen, type of mycosis, and occurrence of AFDR was statistically significant (P ≤ 0.05). The most common fungal specimen isolated was Candida albicans whereas the highest prevalence of AFDR was observed among Candida glabrata. Conclusion: In all the clinical conditions (superficial and deep mycosis), resistance to fluconazole was the predominant type of AFDR. There was a rising trend in the resistance pattern to fluconazole which is one of the most commonly used antifungal agents.
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spelling doaj.art-cd81475f66094ac5a3171e9dbd30fd142024-01-18T11:11:29ZengWolters Kluwer Medknow PublicationsCurrent Medical Issues0973-46512666-40542023-01-0121420821310.4103/cmi.cmi_63_23Changing pattern of antifungal drug resistance in a tertiary health-care facility – A cross-sectional studySatabdi SahuAbinash PandaSuryasnata DashY Roja RamaniJayanti Prava BeheraBackground: Fungal infections remain a major source of morbidity and mortality, but treatment choices are restricted due to limited classes of antifungal agents. The emergence of antifungal drug resistance (AFDR) is a major concern. Understanding trend in the development of AFDR will facilitate the use of therapeutic strategies to overcome and prevent antifungal resistance. The primary objective of the present study was to find out the pattern of AFDR in laboratory-confirmed mycological culture isolates. Methodology: The record-based cross-sectional study was carried out to analyze all the mycological culture sensitivity reports during a period of 3 years. The data set included clinicodemographic parameters such as age, gender, provisional diagnosis, type of culture specimens, identified fungal isolate, and susceptibility pattern. The association between the selected parameters and the pattern of AFDR was found out by Pearson's Chi-squared test. Results: AFDR among the isolates was 22 (75.86%), 8 (61.54%), 25 (100%), and 7 (70%) during the period from 2019 to 2022. The rate of AFDR was 33.87% during the study period. Antifungal susceptibility testing showed a rising trend in fluconazole resistance from 2019 (27.2%) to 2022 (57.1%). AFDR was highest in the age group of 41–60 years (48.3%), in males (72.5%), in skin scrapings (40.3%), and in cases with a provisional diagnosis of deep mycosis (51.6% in deep mycosis vs. 46.7% in superficial mycosis). The association between age, type of clinical specimen, type of mycosis, and occurrence of AFDR was statistically significant (P ≤ 0.05). The most common fungal specimen isolated was Candida albicans whereas the highest prevalence of AFDR was observed among Candida glabrata. Conclusion: In all the clinical conditions (superficial and deep mycosis), resistance to fluconazole was the predominant type of AFDR. There was a rising trend in the resistance pattern to fluconazole which is one of the most commonly used antifungal agents.http://www.cmijournal.org/article.asp?issn=0973-4651;year=2023;volume=21;issue=4;spage=208;epage=213;aulast=Sahuantifungal drug resistanceazolesdeep mycosismultidrug resistancesuperficial mycosis
spellingShingle Satabdi Sahu
Abinash Panda
Suryasnata Dash
Y Roja Ramani
Jayanti Prava Behera
Changing pattern of antifungal drug resistance in a tertiary health-care facility – A cross-sectional study
Current Medical Issues
antifungal drug resistance
azoles
deep mycosis
multidrug resistance
superficial mycosis
title Changing pattern of antifungal drug resistance in a tertiary health-care facility – A cross-sectional study
title_full Changing pattern of antifungal drug resistance in a tertiary health-care facility – A cross-sectional study
title_fullStr Changing pattern of antifungal drug resistance in a tertiary health-care facility – A cross-sectional study
title_full_unstemmed Changing pattern of antifungal drug resistance in a tertiary health-care facility – A cross-sectional study
title_short Changing pattern of antifungal drug resistance in a tertiary health-care facility – A cross-sectional study
title_sort changing pattern of antifungal drug resistance in a tertiary health care facility a cross sectional study
topic antifungal drug resistance
azoles
deep mycosis
multidrug resistance
superficial mycosis
url http://www.cmijournal.org/article.asp?issn=0973-4651;year=2023;volume=21;issue=4;spage=208;epage=213;aulast=Sahu
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