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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 critically ill patients at a major hospital, tracking 120 patients and their fungal infections. Researchers found that diabetes was the most common risk factor, with most fungal infections occurring in urine samples and commonly caused by Candida tropicalis. The study revealed that many fungal strains were resistant to common antifungal drugs like fluconazole, suggesting that doctors need to carefully choose alternative treatments based on each patient’s specific infection type.

Background

Fungal infections remain a significant burden in intensive care units, with incidence rates ranging from 0.22-4.1% in developing countries and 0.024-0.687% in developed nations. Early symptoms of fungal bloodstream infections are often non-specific with low culture-positive rates, leading to frequent misdiagnosis and the need for advanced diagnostic and treatment strategies.

Objective

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

Results

Among 120 patients with mean age 53±15 years, diabetes mellitus was the most prevalent risk factor (50%), followed by chronic liver disease (17.4%). Urine samples revealed fungal infections in 37.8% of cases, predominantly Candida tropicalis (61%), with fluconazole resistance being most common (37%). Mean ICU stay was seven days, with 64% of patients shifted to ward, 14% expired, and 22% discharged.

Conclusion

Fungal isolates exhibit different infection characteristics including site of isolation and resistance patterns, but these differences do not translate to significant disparities in demographic factors or clinical outcomes. The prevalence of fluconazole resistance highlights the need for careful antifungal stewardship and consideration of 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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