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Evaluation of Clinical, Microbiological Profiles and Management Patterns with Outcomes of Patients with Fungal Isolates in An Intensive Care Unit of A Tertiary Care Center: A Prospective Observational Study

Summary

This study examined fungal infections in patients staying in intensive care units at a hospital. Researchers found that diabetes was the most common risk factor, and a fungus called Candida tropicalis was the most frequently isolated organism from urine samples. Many of the fungal strains were resistant to fluconazole, a common antifungal medication, suggesting doctors need to choose different treatments based on which drugs the fungi are resistant to.

Background

Fungal infections remain a significant burden in intensive care units with incidence rates ranging from 0.22-4.1% in developing countries. Early symptoms of fungal bloodstream infections are non-specific, and low culture-positive rates lead to frequent misdiagnosis. Advanced diagnostic mycology laboratories and tailored antifungal strategies are needed, particularly in India.

Objective

To evaluate clinical and microbiological profiles, management patterns, and outcomes of patients with fungal isolates in an ICU setting at a tertiary care center.

Results

Among 120 patients (mean age 53±15 years, 45.6% female), diabetes mellitus was the most prevalent risk factor (50%). Candida tropicalis was the predominant organism (61%) isolated from urine samples (37.8% of cases). Fluconazole resistance was most common (37%), and 64% of patients were shifted to ward, 14% expired, and 22% were discharged.

Conclusion

While fungal isolates exhibit different infection characteristics and resistance patterns, these do not translate to significant disparities in demographics or clinical outcomes except for catheterization. Fluconazole resistance prevalence highlights the need for careful antifungal stewardship and alternative treatment options tailored to resistance profiles.
  • Published in:Indian Journal of Critical Care Medicine,
  • Study Type:Prospective Observational Study,
  • Source: 10.5005/jaypee-journals-10071-24933.140, PMC12168969
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