Epidemiology of Fungal infection in a tertiary care hospital in Northeast India: A Retrospective Study [PART II]

Introduction:

Invassive fungal infection is a common problem faced in ICU’s of all over the world.If we went back to history, It started in 1835 by the discovery of a mould , beauvariabassiana by Agostino Bassi. Then Gruby discovered candidiasis (1842) and Sluyter discovered aspergillosis in 18471,2. The candida albicans was the most predominant yeast in ICUs, which is recently changing to non albicans. 3

Aims and Objectives:

Aim of this study is to find out the commonest fungus in northeast part of India and their sensitivity pattern. This will help in decision making while treating invasive fungal infection in this part of the country.

Materials and Methods:

All the positive cultures of respiratory, urine and blood samples were taken. The duration is from June’2017 till March’2018. A total of 86 positive samples were taken. We will continue to collect data’s and will come up with larger no in future.

Results:

Drugs	Candida Albicans No=56	Candida Tropicalis No=13	Candida Krusei No=2	Candida Glabrata No=6	Candida Parasilopsis No=1	Candida Kefyr No=1	Trichosporon Asahi No1	Aspergillus Fumigatus No=6
Micafungin	All S	All S	All S	All S	All S	All S	All S
Flucytosine	All S	All S	All S	All S	All S	All S	All S
Fluconazole	3 R	All S	2 R	All S	All S	All S	All S
Voriconazole	All S	All S	All S	All S	All S	All S	All S
AmphoB	All S	All S	All S	All S	All S	All S	All S
Caspofungin	All S	All S	All S	1 R	All S	All S	All S

Discussion and Conclusion:

The commonest fungus found in our study is Candida Albicans (65.12%), followed by Candida Tropicalis (15.12%), Candida Glabrata (6.98%) and Aspergillus Fumigatus (6.98%). There is 2 case of Candida Krusei (2.33%) and both are resistant to fluconazole. 1 case of C. Glabrata is intermediately sensitive to caspofungin. There are 1 case each of Candida parapsilosis , Candida Kefyr and Trichosporon Asahi were found. Candida tropicalis is found to be in second position. The third common position is shared by Candida Glabrata and Aspergillus Fumigatus. So Aspergillus Fumigatus is still an important pathogen in this part of India. Emerging fluconazole resistant in albicans and Krusei is an important finding as caspofungin decreased sensitivity to Glabrata.

We are continuing the study and trying to make it multicentre. We will come up with larger pull of data in future.

References:

Kisch B. Forgotten leaders in modern medicine: Valentin, Gruby, Remark, Auerback. Trans Am PhilosSoc1954;44:139-317.
Ajello L. Systemic mycoses in modern medicine. ContrMicrobiolImmunol1977;3:2-6
https://www.ncbi.nlm.nih.gov/pubmed/27837497

Author:

Dr.Apurba Kumar Borah, HOD, Critical Care and Emergency Medicine
Dr. Vicky Lahkar, Consultant Microbiologist
Narayana Superspeciality Hospital, Amingaon, Guwahati, Assam

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