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Invasive candidiasis among high prevalence neurological patients
Weny Rinawati1, July Kumalawati2, Saptawati Bardosono3
1Laboratory of Clinical Pathology and Blood Bank, Mahar Mardjono National Brain Center Hospital, East Jakarta, Indonesia. weny.rinawati@rspon.co.id.
Introduction:
Invasive candidiasis is a severe form of infection. The incidence of invasive fungal infections has increased, due to the increasing number of patients with impaired immunity who are being treated through prolonged stay in hospital facilities. Neurological patient treatment methods such as antimicrobials, corticosteroid, central venous catheter (CVC), total parenteral nutrition, and mechanical ventilation use are associated with common risk factors for invasive candidiasis. Our study demonstrated invasive candidiasis prevalence among neurological patients.
Methodology:
A cross-sectional study was done with consecutive sampling of neurological patients who were hospitalized from January 2017 to February 2020 at the Mahar Mardjono National Brain Center Hospital East Jakarta Indonesia. Patients with sepsis, septic shock, or fever (> 38.5 °C), and who had not received antifungals before culture were enrolled in the study. Clinical specimens were obtained from blood, liquor cerebrospinal or other sterile sites, CVC, respiratory tract specimens, and urine or other non-sterile sites. Socio-demographic data, potential risk factors based on previous studies, clinical, and other tests data were obtained from medical records. Classification of invasive candidiasis was according to the Paphitou classification criteria.
Results:
One hundred and two subjects met the study criteria. The prevalence of invasive candidiasis in neurological patients was 13.7%. All of the isolates were C. parapsilosis.
Conclusions:
The prevalence of invasive candidiasis was high in the samples studied. The infection was associated with septic shock, tracheostomy, and duration of use of central venous catheter, ventilator, and steroids.
Insights
Invasive candidiasis, a severe fungal infection, affects 13.7% of neurological patients. This high prevalence highlights the need for vigilance in managing risk factors like central venous catheters and ventilators in immunocompromised individuals.
Area of Science:
- Infectious Diseases
- Mycology
- Critical Care Medicine
Background:
- Invasive candidiasis is a severe, life-threatening fungal infection.
- Rising incidence linked to increased immunocompromised patient populations and prolonged hospital stays.
- Neurological patients face unique risks due to treatments like central venous catheters (CVCs) and mechanical ventilation.
Purpose of the Study:
- To determine the prevalence of invasive candidiasis among hospitalized neurological patients.
- To identify risk factors associated with invasive candidiasis in this specific patient group.
Main Methods:
- Cross-sectional study conducted from January 2017 to February 2020.
- Inclusion of neurological patients with sepsis, septic shock, or fever, and no prior antifungal use.
- Specimen collection from sterile and non-sterile sites, including blood, cerebrospinal fluid, CVCs, and respiratory samples.
Main Results:
- A total of 102 neurological patients were analyzed.
- The prevalence of invasive candidiasis was found to be 13.7%.
- Candida parapsilosis was the sole species identified in all positive isolates.
Conclusions:
- Invasive candidiasis presents a significant prevalence in the studied neurological patient cohort.
- Key associated risk factors include septic shock, tracheostomy, and prolonged use of CVCs, ventilators, and steroids.
- Findings underscore the importance of monitoring and infection control strategies for invasive candidiasis in neurological intensive care settings.
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