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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 intensive care unit patients at a major hospital in India. Researchers found that diabetes was the most common risk factor, and most infections were caused by Candida species found in urine samples. Many fungal isolates were resistant to common antifungal drugs like fluconazole, suggesting doctors need to be more careful about which medications they use to treat these infections.

Background

Fungal infections remain a significant burden in intensive care units with incidence ranging from 0.22-4.1% in developing countries and 0.024-0.687% in developed nations. Early symptoms are often non-specific and low culture-positive rates lead to frequent misdiagnosis, necessitating advanced diagnostic mycology laboratories and tailored antifungal strategies.

Objective

To evaluate clinical and microbiological profiles, management patterns, and patient outcomes in ICU patients with positive fungal cultures 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%). Urine samples showed fungal infections in 37.8% of cases, predominantly Candida tropicalis (61%). Fluconazole resistance was most common (37%), and 64% of patients were shifted to ward, 14% expired, and 22% were discharged.

Conclusion

While fungal isolates exhibited different infection characteristics and resistance patterns, these differences did not translate to significant disparities in demographic factors or clinical outcomes except for catheterization. The prevalence of fluconazole resistance 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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