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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