Candidaemia and Central Line-Associated Candidaemia in a Network of Indian ICUs: Impact of COVID-19 Pandemic.

IF 4.1 2区医学 Q1 DERMATOLOGY Mycoses Pub Date : 2024-09-01 DOI:10.1111/myc.13790

Purva Mathur, Sharad Srivastav, Arpan Kumar Thakur, Rasna Parveen, Mamta Puraswani, Ashish Kumar Srivastava, Arunaloke Chakrabarti, Camilla Rodrigues, Veeraraghavan Balaji, Pallab Ray, Manisha Biswal, Chand Wattal, Vimala Venkatesh, Nandini Sethuraman, Sanjay Bhattacharya, Vijaya Lakshmi Nag, Vibhor Tak, Bijayini Behera, Neeraj Goel, Jyoti Iravane, Sudipta Mukherjee, Raja Ray, Sanjeev K Singh, Chiranjay Mukhopadhyay, Joy Sarojini Michael, Bashir Ahmad Fomda, Juliah Chelliah, Anjali Shetty, Tadepalli Karuna, Aparna Ningombam, Subodh Kumar, Kapil Dev Soni, Sushma Sagar, Richa Aggrawal, Deepak Gupta, Gyaninder Pal Singh, Ashish Bindra, Kamran Farooque, Shashank Purwar, Sagar Khadanga, K E Vandana, Muralidhar Varma, Vijayshri Deotale, Padma Das, Ruchita Lohiya, Amber Prasad, Puneet Kumar Gupta, Balram Ji Omar, Ankit Aggarwal, Sherish Baqal, Khuraijam Ranjana Devi, L Chaoba Singh, Soumyadip Chatterji, Gaurav Goel, Satyam Mukherjee, Yamunadevi V Ramanathan, Aparna Sonowal, Prachi Verma, Ashoka Mahapatra, Vinaykumar Hallur, Ujjwala Nitin Gaikwad, Anudita Bhargava, Kanne Padmaja, Nagari Bheerappa, Vidhi Jain, Pradeep Bhatia, Kuldeep Singh, Daisy Khera, Neeraj Gupta, Hema Paul, Sheetal Verma, Zia Arshad, Ratinder Jhaj, Shikha Malik, M A Thirunarayan, Hirak Jyoti Raj, Prashant Gupta, Dandu Himanshu, Shivaprakash M Rudramurthy, Reema Nath, Renu Gur, Nari M Lyngdoh, Clarissa Lyngdoh, Sheela Devi, Shalini Malhotra, Rajni Gaind, Rushika Saksena, Rajni Sharma, Kamini Walia

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引用次数: 0

Abstract

Background and objectives: Candidaemia is a potentially life-threatening emergency in the intensive care units (ICUs). Surveillance using common protocols in a large network of hospitals would give meaningful estimates of the burden of candidaemia and central line associated candidaemia in low resource settings. We undertook this study to understand the burden and epidemiology of candidaemia in multiple ICUs of India, leveraging the previously established healthcare-associated infections (HAI) surveillance network. Our aim was also to assess the impact that the pandemic of COVID-19 had on the rates and associated mortality of candidaemia.

Methods: This study included adult patients from 67 Indian ICUs in the AIIMS-HAI surveillance network that conducted BSI surveillance in COVID-19 and non-COVID-19 ICUs during and before the COVID-19 pandemic periods. Hospitals identified healthcare-associated candidaemia and central line associated candidaemia and reported clinical and microbiological data to the network as per established and previously published protocols.

Results: A total of 401,601 patient days and 126,051 central line days were reported during the study period. A total of 377 events of candidaemia were recorded. The overall rate of candidaemia in our network was 0.93/1000 patient days. The rate of candidaemia in COVID-19 ICUs (2.52/1000 patient days) was significantly higher than in non-COVID-19 ICUs (1.05/patient days) during the pandemic period. The rate of central line associated candidaemia in COVID-19 ICUs (4.53/1000 central line days) was also significantly higher than in non-COVID-19 ICUs (1.73/1000 central line days) during the pandemic period. Mortality in COVID-19 ICUs associated with candidaemia (61%) was higher than that in non-COVID-19 ICUs (41%). A total of 435 Candida spp. were isolated. C. tropicalis (26.7%) was the most common species. C. auris accounted for 17.5% of all isolates and had a high mortality.

Conclusion: Patients in ICUs with COVID-19 infections have a much higher risk of candidaemia, CLAC and its associated mortality. Network level data helps in understanding the true burden of candidaemia and will help in framing infection control policies for the country.

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印度重症监护室网络中的念珠菌血症和中央管路相关念珠菌血症：COVID-19 大流行的影响。

背景和目的：念珠菌血症是重症监护病房（ICU）中可能危及生命的急症。在大型医院网络中使用通用协议进行监测，可对低资源环境中念珠菌血症和中央管路相关念珠菌血症的负担做出有意义的估计。我们利用以前建立的医疗相关感染（HAI）监测网络开展了这项研究，以了解印度多个重症监护病房的念珠菌血症负担和流行病学。我们的目的还在于评估 COVID-19 大流行对念珠菌血症发病率和相关死亡率的影响：本研究纳入了 AIIMS-HAI 监控网络中 67 个印度 ICU 的成年患者，这些 ICU 在 COVID-19 大流行期间和之前对 COVID-19 和非 COVID-19 ICU 进行了 BSI 监控。各医院按照先前公布的既定规程确定了医源性念珠菌血症和中央管路相关念珠菌血症，并向网络报告了临床和微生物学数据：研究期间共报告了 401,601 个患者日和 126,051 个中心管路日。共记录了 377 例念珠菌血症。在我们的网络中，念珠菌血症的总发生率为 0.93/1000 个患者日。在大流行期间，COVID-19 重症监护病房的念珠菌血症发生率（2.52/1000 患者日）明显高于非 COVID-19 重症监护病房（1.05/患者日）。在大流行期间，COVID-19 重症监护病房的中心管路相关念珠菌血症发生率（4.53/1000 中心管路日）也明显高于非 COVID-19 重症监护病房（1.73/1000 中心管路日）。与念珠菌血症相关的 COVID-19 ICU 死亡率（61%）高于非 COVID-19 ICU 死亡率（41%）。共分离出 435 个念珠菌属。热带念珠菌（26.7%）是最常见的菌种。在所有分离菌中，白色念珠菌占17.5%，死亡率较高：结论：感染 COVID-19 的重症监护病房患者发生念珠菌血症、CLAC 及其相关死亡率的风险要高得多。网络层面的数据有助于了解念珠菌血症的真正负担，并有助于制定国家感染控制政策。

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来源期刊

Mycoses 医学-皮肤病学

CiteScore

10.00

自引率

8.20%

发文量

143

审稿时长

6-12 weeks

期刊介绍： The journal Mycoses provides an international forum for original papers in English on the pathogenesis, diagnosis, therapy, prophylaxis, and epidemiology of fungal infectious diseases in humans as well as on the biology of pathogenic fungi. Medical mycology as part of medical microbiology is advancing rapidly. Effective therapeutic strategies are already available in chemotherapy and are being further developed. Their application requires reliable laboratory diagnostic techniques, which, in turn, result from mycological basic research. Opportunistic mycoses vary greatly in their clinical and pathological symptoms, because the underlying disease of a patient at risk decisively determines their symptomatology and progress. The journal Mycoses is therefore of interest to scientists in fundamental mycological research, mycological laboratory diagnosticians and clinicians interested in fungal infections.