Invasive Candidiasis in Indian ICU -...
Transcript of Invasive Candidiasis in Indian ICU -...
Invasive Candidiasis in Indian ICU
Outbreak in Indian Scenario
Dr Bansidhar Tarai
Sr Consultant Microbiology
Max Super Specialty Hospital , Saket, New Delhi
Outbreak in Indian Scenario Invasive Candidiasis in Indian ICU
• Fungal outbreak is uncommon
• Mainly in hospital setting in susceptible individuals
• Limited data , Difficult to find RCA
• Mainly of Candida outbreak
• Outbreak of fungal meningitis in USA 2012 , contaminated
preservative free MPA steroids injections (local spinal) – Exeserohilum rostratum and one case of A.fumigatus
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All over the world - a review
few reports in India - a review
Journal of Medical Microbiology (2007), 56, 185–189
During April 2011 - September 2012
In a multi-centric (28 centers) study conducted in India - the prevalence of
candidemia
in ICU patients, C. auris was recognized as the fourth most common etiologic agent.
A total of 111 suspected isolates of Candida auris were obtained from 104 cases
Vitek2 system identified 107 (96.39%) isolates as C. haemulonii, 1 (0.9%) isolate as
C. utilis, and 1 (0.9%) isolate as C. pulcherrima.
Sequencing of D1/D2 region of 26S rDNA and ITS region identified 100 (90.1)
suspected isolates as C. auris.
Conclusion
• Infection control practices
– Infection control committee
– periodic surveillance cultures
• Hand hygiene compliance & monitoring
• Environmental cleaning
– Temperature and humidity monitoring
– AC/ HEPA filter cleaning
• Overuse of Fluconazole prophylaxis
• High risk factors
– Longer hospitalisations, Central lines, catheters, mechanical
ventilations,
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