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Low Colonisation Rate of Candida auris in Patients of Intensive Care Units: A Study From Central India
Surabhi Sahay1, Archana Keche2, Padma Das2
1Ophthalmology, All India Institute of Medical Sciences, New Delhi, New Delhi, IND.
Abstract:
Introduction Invasive candidiasis is associated with increased morbidity and mortality in critically ill patients. Candida auris (C. auris) is a growing concern in healthcare settings, especially in intensive care units (ICUs), due to its rapid spread, limited treatment options, and high mortality risk, posing a substantial challenge for physicians. In this study, we aimed to estimate the prevalence of C. auris colonization in patients admitted to ICUs of a tertiary care centre in central India. Methods A composite swab from the axilla and groin of patients at the time of admission and one week after admission was collected and subjected to culture and identification by conventional methods and using the Vitek 2 Yeast Identification System. Data from the case record forms were compiled in an Excel sheet (Microsoft® Corp., Redmond, WA) and analysed. Descriptive statistics, including frequency, mean, and standard deviation, were calculated for the demographic data. All statistical analyses were performed using Epi Info (version 7.2.5.0; Centers for Disease Control and Prevention, Atlanta, GA). Results Out of the 67 patients enrolled in the study, follow-up samples after one week of admission were only possible for 37 of the patients. Overall, a total of 18 Candida isolates were obtained from 67 patients, out of which, only one isolate (5.55%) was identified as C. auris. Other species of Candida were Candida glabrata (13), Candida parapsilosis (three), and Candida tropicalis (one). Candida colonisation was seen more in patients on meropenem and amoxicillin-clavulanate acid (p=0.02). Conclusion The low detection rate of C. auris colonisation among ICU patients in this study suggests limited spread within the facility during the study period. However, the overall Candida colonisation, particularly among patients receiving broad-spectrum antibiotics, highlights the importance of antimicrobial stewardship and active surveillance.
Insights
This study found a low prevalence of Candida auris colonization in intensive care unit patients in central India. Overall Candida colonization was higher in patients receiving broad-spectrum antibiotics, emphasizing antimicrobial stewardship.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Medical Microbiology
Background:
- Invasive candidiasis, particularly from Candida auris, poses significant risks in intensive care units (ICUs).
- Candida auris presents challenges due to rapid spread, limited treatment options, and high mortality.
- Physicians face substantial difficulties in managing Candida auris infections in critically ill patients.
Purpose of the Study:
- To determine the prevalence of Candida auris colonization in ICU patients.
- To assess the spread of Candida auris within a tertiary care center in central India.
Main Methods:
- Composite swabs (axilla and groin) were collected from ICU patients upon admission and one week later.
- Samples were cultured and identified using conventional methods and the Vitek 2 Yeast Identification System.
- Data analysis included descriptive statistics and statistical analysis using Epi Info.
Main Results:
- Only one isolate (5.55%) of Candida auris was identified among 18 Candida isolates from 67 patients.
- Candida glabrata was the most common species (13 isolates), followed by Candida parapsilosis (3) and Candida tropicalis (1).
- Candida colonization was significantly associated with the use of meropenem and amoxicillin-clavulanate (p=0.02).
Conclusions:
- The study indicates a limited spread of Candida auris within the ICU during the study period.
- Overall Candida colonization, especially in patients on broad-spectrum antibiotics, underscores the need for antimicrobial stewardship.
- Active surveillance for Candida species in ICUs is crucial for effective management and infection control.
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