%0 Journal Article
%T Epidemiology and Virulence Determinants including Biofilm Profile of Candida Infections in an ICU in a Tertiary Hospital in India
%A Ravinder Kaur
%A Ritu Goyal
%A Megh S. Dhakad
%A Preena Bhalla
%A Rakesh Kumar
%J Journal of Mycology
%D 2014
%I Hindawi Publishing Corporation
%R 10.1155/2014/303491
%X The purpose of this prospective study was to isolate, speciate, and determine antifungal susceptibility and virulence patterns of Candida species recovered from the intensive care units (ICUs) in an Indian hospital. Study included 125 medical/postoperative patients admitted to ICU. Identification and speciation of yeast isolates were done by the biochemical methods. Antifungal susceptibility was done by broth microdilution method. Virulence testing of Candida species was done by phospholipase, proteinase, and adherence assay. A total of 103 Candida isolates were isolated; C. tropicalis was the predominant species (40.7%), followed by C. albicans (38.83 %), C. glabrata (11.65%), C. parapsilosis (3.88%), and 1.94% each of C. krusei, C. kefyr, and C. sphaerica. 60 Candida isolates (58.25%) showed resistance to fluconazole, while 7 (6.7%) isolates showed resistance to amphotericin B. Phospholipase and proteinase activities were seen in 73.8% and 55.3% Candida isolates with different species showing a wide range of activities, while 68.9% Candida isolates showed {4+} adherence activity. The present study revealed that nonalbicans Candida species (NAC spp.) caused most of the cases of Candidemia in the ICU patients. The isolation of C. tropicalis from a large number of cases highlights the ability of this pathogen to cause bloodstream infections. The presence of azole resistance is a matter of concern. 1. Introduction Fungal infections are emerging as a problem of significant magnitude in hospitals during the last decade, especially in the ICUs, which are epicenters for infections such as Candidemia and invasive Candida infection (ICI). The escalating problem in ICUs is probably due to an increasing population of immunocompromised patients. A survey of the epidemiology of sepsis conducted in USA revealed that the incidence of fungal sepsis increased threefold between 1979 and 2000 [1]. Fungal infections account for nearly 8% of all nosocomial infections; Candida is the responsible agent in 80% of the cases [2]. Candida species are approximately the fourth most common cause of nosocomial infections in ICUs, according to data from the National Nosocomial Infections Surveillance System and the European Prevalence of Infection in Intensive Care [3]. Critically ill patients who are treated in the ICUs are very susceptible to infections due to acquired defects in host defense mechanisms from the immunosuppressive effect of the underlying disease, recent surgery, trauma, and concurrent drug therapy. Infections occur in 15¨C40% of all ICU admissions and central venous
%U http://www.hindawi.com/journals/jmy/2014/303491/