18 research outputs found
Predictors of candidemia in pediatric patients (0–12 years) admitted in a tertiary care hospital of Northern India
Background: Bloodstream infections due to Candida species are becoming a major cause of morbidity and mortality in hospitalized patients. The emergence of non-albicans Candida (NACs) species with lesser susceptibility to antifungals has added to the woes of clinicians. Objectives: The objectives of the study were to determine the clinical and laboratory predictors and microbiological profile of candidemia in pediatric patients. Materials and Methods: This is a hospital-based, prospective, and cross-sectional study conducted in the pediatric department of a tertiary care hospital. A total of 250 children aged 0–12 years with risk factors for fungal sepsis were enrolled. Demographic details, clinical, and laboratory parameters were noted and samples were sent for culture. Cultures yielding growth of Candida were included in the study, and antifungal susceptibility performed. Associations were assessed using Chi-square test first and then through logistic regression models. Results: Among the 250 patients with risk factors for fungal sepsis, 47 patients (18.8%) with culture proven candidemia were identified. Predictors of candidemia among neonates were prematurity (<30 weeks), prolonged ventilation (>72 h), and thrombocytopenia. Among pediatric patients, prolonged steroid intake, Candida isolation from sites other than blood and persistent neutropenia, were significantly associated with the candidemia. NAC species were the predominant isolates (78.7%). Conclusion: Candidemia should be suspected in premature neonates requiring prolonged ventilation with unexplained thrombocytopenia. Among pediatric patients, prolonged steroid intake, Candida isolation from sites other than blood and persistent neutropenia are predictors of candidemia
Standardization of first and second-line antitubercular susceptibility testing using BacT Alert 3D system: a report from a tertiary care centre in India
Spectrum of fungal infection in head and neck cancer patients on chemoradiotherapy
Background: Radiotherapy for head and neck cancers (HNC) causes alteration of oral mucosal barrier predisposing it to colonization and infection. Such infections often result in pain and burning sensation thus contributing to major morbidity.
Objective:
1. To identify the fungi isolated from the patients undergoing radiotherapy for HNC.
2. To determine their antifungal susceptibility and week of colonization.
3. To find out association between oral fungal infection and severity of oral mucositis.
Materials and methods: Study was done on 50 patients of HNC treated with concurrent chemoradiotherapy. Three samples (throat, urine, blood) were collected for fungal culture and sensitivity. These samples were collected before the start of radiotherapy, during radiotherapy (2nd and 6th week) and post radiotherapy (10th week).
Results: Only 49 patients were available for analysis. Fungal infection was found in 27/49 patients (55.10%) out of which Non-albicans Candida was isolated in 18/49 (36.73%) and Candida albicans in 9/49 (18.36%) cases. About 66.66% (18/27) isolates were sensitive to fluconazole. Maximum isolation of yeast was during 6th week of radiotherapy. All grade 4 and 71.42% of grade 3 oral mucositis were found in patients who were positive for fungal infection.
Conclusion: The spectrum of fungal species in throat swab was: Non-albicans Candida and Candida albicans observed in 36.73% and 18.36% of patients respectively. Higher rate of fungal colonization and infection was found in patients with grade 3/4 oral mucositis. Prophylactic fluconazole in HNC patients on concurrent chemoradiotherapy has the potential to reduce emerging invasive fungal infection and its associated morbidity
Concomitant Infections of Influenza A H1N1 and Disseminated Cryptococcosis in an HIV Seropositive Patient
Respiratory viral infections, especially influenza have a potential to form a fatal association with cryptococcosis in the setting of compromised immunity. Considering the lethality of these two infections, we report an unusual case of dual infection of pandemic influenza A H1N1 and disseminated cryptococcosis in an HIV seropositive individual
Rapid diagnosis of community-acquired pneumonia using the Bac T/ alert 3D system
We compared BacT/Alert 3D with conventional culture for the diagnosis of community-acquired pneumonia (CAP). Antimicrobial susceptibility testing of the isolates was performed with the disk diffusion method, and the minimum inhibitory concentration (MIC) was calculated. Automation was superior in terms of recovery and time to detect pathogens. The bacterial spectrum in CAP was Streptococcus pneumoniae (35.3%) Staphylococcus aureus (23.5%), Klebsiella pneumoniae (20.5%) and Haemophilus influenzae (8.8%). Three of the 12 S. pneumoniae isolates showed penicillin resistance on MIC and two showed erythromycin resistance. There were two H. influenzae strains resistant to penicillin; these were beta lactamase producers. One-fourth of the S. aureus were oxacillin resistant. All isolates were sensitive to cefepime by disc diffusion and MIC methods. In the treatment of CAP, cefotaxime and cefepime are useful drugs when given as empirical therapy against multidrug resistant strains. The use of automation is vital in CAP, as rapid diagnosis and effective therapy can reduce mortality
Scedosporium apiospermum, an emerging pathogen in India: Case series and review of literature
Scedosporium apiospermum is a rare cause of infection but is increasingly being reported among immunocompromised individuals around the world. We report two cases of S. apiospermum, one of keratitis and the other of nasal polyp both from immunocompetent patients. The two cases were successfully treated with voriconazole. It is important to diagnose such infections as their antifungal susceptibility to amphotericin B is variable