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Epidemiology of Candida colonization in medical surgical intensive care unit of a tertiary care teaching hospital of North India

Year 2018, Volume: 08 Issue: 04, 147 - 152, 15.12.2018
https://doi.org/10.5799/jmid.493851

Abstract

Objective: Invasive candidiasis is associated with increased
morbidity and mortality in critically ill patients. Current study was undertaken
to study the colonization trend in critically ill patients admitted to a
medical /surgical ICU of a tertiary care teaching hospital.



Methodology: Data for the current study has been derived from a
larger database generated for external validation of risk prediction scores for
invasive candidiasis conducted in a 12 bedded medical/surgical ICU of a
tertiary care hospital of North India. Non neutropenic adult patients with
>48 hours of ICU stay were included in the study. Colonization surveillance
samples were collected from oral cavity, endotracheal aspirates, axilla,
perineum and urine at the time of admission and then on 3rd, 7th,
14th and 21st day of ICU stay. Blood culture samples were
taken at admission and then as per physician’s discretion.



Results:
Total 200 patients were enrolled from July 2013 to November 2014. Ninety five
percent patients were colonized with Candida
either at admission or during their stay in ICU. The most common species
responsible for colonization was Candida
glabrata
(27%) followed by C.
tropicalis
(20.5%) and C. auris
(18%). Seventeen patients developed Candida
blood stream infection. C. tropicalis
was the most common species causing candidemia. C.auris was most frequent
colonizer of axilla (54.2%), while rectal swabs had high growth of C. glabrata (44.9%).



Conclusion: Our study population had high rate of Candida colonization. C. glabrata was the most common
colonizer followed by C. tropicalis.  J
Microbiol Infect Dis 2018; 8(4):147-152.

References

  • 1. Umscheid CA, Mitchell MD, Doshi JA, Agarwal R, Williams K, Brennan PJ. Estimating the proportion of healthcare-associated infections that are reasonably preventable and the related mortality and costs.Infect Control HospEpidemiol 2011; 32(2):101-14. 2. De Rosa FG, Corcione S, Pagani N, Di PerriG. From ESKAPE to ESCAPE, from KPC to CCC.Clin Infect Dis 2015; 60 (8):1289-1290. 3. De Rosa FG, Corcione S, Raviolo S, et al. Candidemia, and infections by Clostridium difficile and carbapenemase-producing Enterobacteriaceae: new enteropathogenetic opportunistic syndromes? Infez Med 2015; 23(2):105-116. 4. Kullberg BJ, Arendrup MC. Invasive Candidiasis. N Engl J Med 2015; 373(15):1445-1456. 5. Pittet D, Monod M, Suter PM, Frenk E, Auckenthaler R. Candida colonization and subsequent infections in critically ill surgical patients.Ann Surg 1994; 220(6):751-758. 6. Eggimann P, Pittet D. Candida colonization index and subsequent infection in critically ill surgical patients: 20 years later. Intensive Care Med 2014; 40(10):1429-1448. 7. León C, Ruiz-Santana S, Saavedra P, et al. Study Group. A bedside scoring system ("Candidascore") for early antifungal treatment in nonneutropenic critically ill patients withCandida colonization.Crit Care Med 2006; 34(3):730-737. 8. León C, Ruiz-Santana S, Saavedra P, et al. Cava Study Group. Usefulness of the "Candidascore" for discriminating between Candida colonization and invasive candidiasis in non-neutropenic critically ill patients: a prospective multicenter study.Crit Care Med 2009; 37 (5):1624-1633. 9. Schulte DM, Sethi A, Gangnon R, Duster M, Maki DG, Safdar N. Risk factors for Candida colonization and Co-colonization with multi-drug resistant organisms at admission. Antimicrob Resist Infect Control 2015; 4:46. 10. Hamet M, Pavon A, Dalle F, et al. Candida spp. airway colonization could promote antibiotic-resistant bacteria selection in patients with suspected ventilator-associated pneumonia. Intensive Care Med 2012; 38 (8):1272-1279. 11. Ricard JD, Roux D. Candida colonization in ventilated ICU patients: no longer a bystander! Intensive Care Med 2012; 38(8):1243-1245. 12. Lau AF, Kabir M, Chen SC, et al.Candida colonization as a risk marker for invasive candidiasis in mixed medical-surgical intensive care units: development and evaluation of a simple, standard protocol. J Clin Microbiol 2015; 53 (4):1324-1330. 13. Ahmed A, Baronia AK, Azim A, et al. External Validation of Risk Prediction Scores for Invasive Candidiasis in a Medical/Surgical Intensive Care Unit: An Observational Study. Indian J Crit Care Med 2017; 21(8):514-520. 14. Nace HL, Horn D, Neofytos D. Epidemiology and outcome of multiple-species candidemia at a tertiary care center between 2004 and 2007. Diagn Microbiol Infect Dis 2009;64:289-294. 15. Chakrabarti A, Sood P, Rudramurthy SM, et al. Incidence, characteristics and outcome of ICU-acquired candidemia in India.Intensive Care Med 2015; 41 (2):285-295.
Year 2018, Volume: 08 Issue: 04, 147 - 152, 15.12.2018
https://doi.org/10.5799/jmid.493851

Abstract

References

  • 1. Umscheid CA, Mitchell MD, Doshi JA, Agarwal R, Williams K, Brennan PJ. Estimating the proportion of healthcare-associated infections that are reasonably preventable and the related mortality and costs.Infect Control HospEpidemiol 2011; 32(2):101-14. 2. De Rosa FG, Corcione S, Pagani N, Di PerriG. From ESKAPE to ESCAPE, from KPC to CCC.Clin Infect Dis 2015; 60 (8):1289-1290. 3. De Rosa FG, Corcione S, Raviolo S, et al. Candidemia, and infections by Clostridium difficile and carbapenemase-producing Enterobacteriaceae: new enteropathogenetic opportunistic syndromes? Infez Med 2015; 23(2):105-116. 4. Kullberg BJ, Arendrup MC. Invasive Candidiasis. N Engl J Med 2015; 373(15):1445-1456. 5. Pittet D, Monod M, Suter PM, Frenk E, Auckenthaler R. Candida colonization and subsequent infections in critically ill surgical patients.Ann Surg 1994; 220(6):751-758. 6. Eggimann P, Pittet D. Candida colonization index and subsequent infection in critically ill surgical patients: 20 years later. Intensive Care Med 2014; 40(10):1429-1448. 7. León C, Ruiz-Santana S, Saavedra P, et al. Study Group. A bedside scoring system ("Candidascore") for early antifungal treatment in nonneutropenic critically ill patients withCandida colonization.Crit Care Med 2006; 34(3):730-737. 8. León C, Ruiz-Santana S, Saavedra P, et al. Cava Study Group. Usefulness of the "Candidascore" for discriminating between Candida colonization and invasive candidiasis in non-neutropenic critically ill patients: a prospective multicenter study.Crit Care Med 2009; 37 (5):1624-1633. 9. Schulte DM, Sethi A, Gangnon R, Duster M, Maki DG, Safdar N. Risk factors for Candida colonization and Co-colonization with multi-drug resistant organisms at admission. Antimicrob Resist Infect Control 2015; 4:46. 10. Hamet M, Pavon A, Dalle F, et al. Candida spp. airway colonization could promote antibiotic-resistant bacteria selection in patients with suspected ventilator-associated pneumonia. Intensive Care Med 2012; 38 (8):1272-1279. 11. Ricard JD, Roux D. Candida colonization in ventilated ICU patients: no longer a bystander! Intensive Care Med 2012; 38(8):1243-1245. 12. Lau AF, Kabir M, Chen SC, et al.Candida colonization as a risk marker for invasive candidiasis in mixed medical-surgical intensive care units: development and evaluation of a simple, standard protocol. J Clin Microbiol 2015; 53 (4):1324-1330. 13. Ahmed A, Baronia AK, Azim A, et al. External Validation of Risk Prediction Scores for Invasive Candidiasis in a Medical/Surgical Intensive Care Unit: An Observational Study. Indian J Crit Care Med 2017; 21(8):514-520. 14. Nace HL, Horn D, Neofytos D. Epidemiology and outcome of multiple-species candidemia at a tertiary care center between 2004 and 2007. Diagn Microbiol Infect Dis 2009;64:289-294. 15. Chakrabarti A, Sood P, Rudramurthy SM, et al. Incidence, characteristics and outcome of ICU-acquired candidemia in India.Intensive Care Med 2015; 41 (2):285-295.
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Details

Primary Language English
Journal Section ART
Authors

Afzal Azim This is me

Armin Ahmed This is me

Arvind Kumar Baronia This is me

Reema Yadav This is me

Preeti Sharma This is me

Rungmei S. K. Marak This is me

Publication Date December 15, 2018
Published in Issue Year 2018 Volume: 08 Issue: 04

Cite

APA Azim, A., Ahmed, A., Baronia, A. K., Yadav, R., et al. (2018). Epidemiology of Candida colonization in medical surgical intensive care unit of a tertiary care teaching hospital of North India. Journal of Microbiology and Infectious Diseases, 08(04), 147-152. https://doi.org/10.5799/jmid.493851
AMA Azim A, Ahmed A, Baronia AK, Yadav R, Sharma P, Marak RSK. Epidemiology of Candida colonization in medical surgical intensive care unit of a tertiary care teaching hospital of North India. J Microbil Infect Dis. December 2018;08(04):147-152. doi:10.5799/jmid.493851
Chicago Azim, Afzal, Armin Ahmed, Arvind Kumar Baronia, Reema Yadav, Preeti Sharma, and Rungmei S. K. Marak. “Epidemiology of Candida Colonization in Medical Surgical Intensive Care Unit of a Tertiary Care Teaching Hospital of North India”. Journal of Microbiology and Infectious Diseases 08, no. 04 (December 2018): 147-52. https://doi.org/10.5799/jmid.493851.
EndNote Azim A, Ahmed A, Baronia AK, Yadav R, Sharma P, Marak RSK (December 1, 2018) Epidemiology of Candida colonization in medical surgical intensive care unit of a tertiary care teaching hospital of North India. Journal of Microbiology and Infectious Diseases 08 04 147–152.
IEEE A. Azim, A. Ahmed, A. K. Baronia, R. Yadav, P. Sharma, and R. S. K. Marak, “Epidemiology of Candida colonization in medical surgical intensive care unit of a tertiary care teaching hospital of North India”, J Microbil Infect Dis, vol. 08, no. 04, pp. 147–152, 2018, doi: 10.5799/jmid.493851.
ISNAD Azim, Afzal et al. “Epidemiology of Candida Colonization in Medical Surgical Intensive Care Unit of a Tertiary Care Teaching Hospital of North India”. Journal of Microbiology and Infectious Diseases 08/04 (December 2018), 147-152. https://doi.org/10.5799/jmid.493851.
JAMA Azim A, Ahmed A, Baronia AK, Yadav R, Sharma P, Marak RSK. Epidemiology of Candida colonization in medical surgical intensive care unit of a tertiary care teaching hospital of North India. J Microbil Infect Dis. 2018;08:147–152.
MLA Azim, Afzal et al. “Epidemiology of Candida Colonization in Medical Surgical Intensive Care Unit of a Tertiary Care Teaching Hospital of North India”. Journal of Microbiology and Infectious Diseases, vol. 08, no. 04, 2018, pp. 147-52, doi:10.5799/jmid.493851.
Vancouver Azim A, Ahmed A, Baronia AK, Yadav R, Sharma P, Marak RSK. Epidemiology of Candida colonization in medical surgical intensive care unit of a tertiary care teaching hospital of North India. J Microbil Infect Dis. 2018;08(04):147-52.