Acta Scientific Medical Sciences (ASMS)(ISSN: 2582-0931)

Research Article Volume 7 Issue 9

Invasive Fungal Infections in A Teritiary ICU in Hyderabad

Sudeep Sirga1, K Hima Bindu2*, Ratnamani MS3, Jamadanda Prathiba4, Nagaraju Gorla5, Chandana Lakkoju6, Sai Druthi Pasupuleti6 and Subbareddy Kesavarapu7

1Senior Consultant, Department of Critical Care, Apollo Hospitals, Jubilee Hills, Hyderabad, India
2Consultant, Department of Critical Care, Apollo Hospitals, Jubilee Hills, Hyderabad, India
3Senior Consultant and HOD, Department of Microbiology, Hyderabad, India
4Senior Consultant, Department of Microbiology, Hyderabad, India
5Senior Consultant, Department of Critical Care, Apollo Hospitals, Jubilee Hills, Hyderabad, India
6Registrar, Department of Critical Care, Apollo Hospitals, Jubilee Hills, Hyderabad, India
7Senior Consultant and HOD, Department of Critical Care, Apollo Hospitals, Jubilee Hills, Hyderabad, India

*Corresponding Author: K Hima Bindu, Consultant, Department of Critical Care, Apollo Hospitals, Jubilee Hills, Hyderabad, India.

Received: August 22, 2023; Published: August 31, 2023

Abstract

The COVID-19 pandemic has caused more than 500 million cases and 6 million fatalities globally, with India particularly heavily struck by the second wave. This has significantly increased the prevalence of invasive fungal diseases, such as COVID-19-associated pulmonary mucormycosis (CAPM) and COVID-associated pulmonary aspergillosis.
A retrospective study was conducted to examine the incidence of IFI in a tertiary care ICU in South India during the pandemic. Data was collected from medical records of patients with documented positive fungal cultures. Results showed that the incidence of COVID-19-associated pulmonary mucormycosis (CAPM) and COVID-associated pulmonary aspergillosis had increased significantly.
The study examined 41 medical and surgical patients admitted to ICU in a tertiary care hospital in Hyderabad from January 2020 – December 2022 with documented culture-positive invasive fungal infections. The most common source of fungal infection was from lung, followed by the maxillary sinus tissue, nasal cavity, peritoneal fluid, Frontal sinus tissue, and urine. Fungal cultures were positive in 36 cases (87.8%) and negative in 1, and not done in 4 patients. Rhizopus was the first most frequently identified fungus, followed by Aspergillus flavus (26.8%), Aspergillus fumigatus (7.3%), Aspergillus niger (7.3%), Candida tropicalis and albicans (2.4%), Candida parapsilosis (7.3%), Mucormycosis (2.4%), and seedosporium (2.4%).

Keywords: Invasive Fungal Infections; COVID 19; Mucor; Aspergillus; Critical Care; Candida

References

  1. COVID-19 Map - Johns Hopkins Coronavirus Resource Center
  2. White PL., et al. “A national strategy to diagnose coronavirus disease 2019-associated invasive fungal disease in the intensive care unit”. Clinical Infectious Diseases. Oxford Academic 73 (2021): e1634-1644.
  3. Bartoletti M., et al. “Epidemiology of invasive pulmonary aspergillosis among intubated patients with COVID-19: a prospective study”. Clinical Infectious Diseases 73 (2021): 3606-3620.
  4. Prattes J., et al. “Risk factors and outcome of pulmonary aspergillosis in critically ill coronavirus disease 2019 patients-a multinational observational study by the European Confederation of Medical Mycology”. Clinical Microbiology and Infection. Elsevier 28 (2022): 580-587.
  5. Singh S., et al. “Mortality in critically ill patients with coronavirus disease 2019-associated pulmonary aspergillosis: a systematic review and meta-analysis. Mycoses”. John Wiley and Sons, Ltd 64 (2021): 1015-1027.
  6. Mitaka H., et al. “Incidence and mortality of COVID-19-associated pulmonary aspergillosis: a systematic review and meta-analysis. Mycoses”. John Wiley and Sons, Ltd 64 (2021): 993-1001.
  7. Er B., et al. “A screening study for COVID-19-associated pulmonary aspergillosis in critically ill patients during the third wave of the pandemic. Mycoses”. John Wiley and Sons, Ltd (2022).
  8. Baddley JW., et al. “Coronavirus disease 2019-associated invasive fungal infection”. Open Forum Infectious Diseases (2021): 8. 
  9. Gangneux J-P., et al. “Fungal infections in mechanically ventilated patients with COVID-19 during the first wave: the French multicentre MYCOVID study”. The Lancet Respiratory Medicine 10 (2022): 180-190.
  10. Permpalung N., et al. “Coronavirus disease 2019-associated pulmonary aspergillosis in mechanically ventilated patients”. Clinical Infectious Diseases. Oxford Academic 74 (2022): 83-91.
  11. Costantini C., et al. “Covid-19-Associated Pulmonary Aspergillosis: The Other Side of the Coin”. Vaccines (Basel) 4 (2020): 713.
  12. Werthman-Ehrenreich A. “Mucormycosis with orbital compartment syndrome in a patient with COVID-19”. The American Journal of Emergency Medicine 42 (2021): 264.e5. 
  13. Moorthy A., et al. “SARS-CoV-2, Uncontrolled Diabetes and Corticosteroids-An Unholy Trinity in Invasive Fungal infections of the maxillofacial region? A retrospective, multi-centric analysis”. Journal of Maxillofacial and Oral Surgery 6 (2021): 1-8. 
  14. Hoenigl M. “Invasive Fungal disease complicating coronavirus disease 2019: When it rains, it spores”. Clinical Infectious Diseases 7 (2020): e1645-e1648. 
  15. Prakash H and Chakrabarti A. “Epidemiology of mucormycosis in India”. Microorganism 9.3 (2021): 523-534. 
  16. Gangneux JP., et al. “Invasive fungal diseases during COVID-19: We should be prepared”. Journal de Mycologie Medicale 2 (2020): 100971.
  17. Zhang H., et al. “Risks and features of secondary infections in severe and critical ill COVID-19 patients”. Emerging Microbes and Infections 1 (2020): 1958-1964.
  18. Qin C., et al. “Dysregulation of immune response in patients with coronavirus 2019 (COVID-19) in Wuhan, China”. Clinical Infectious Diseases 15 (2020): 762-829.
  19. Jafarzadeh A., et al. “Lymphopenia an important immunological abnormality in patients with COVID-19: possible mechanisms”. Scandinavian Journal of Immunology 2 (2021): e12967.
  20. Khalil MA., et al. “Oropharyngeal Candidiasis among egyptian COVID-19 patients: clinical characteristics, Species Identification, and Antifungal susceptibility, with Disease Severity and Fungal Coinfection Prediction Models”. Diagnostics7 (2022): 1719.
  21. Tahamtan A and Ardebili A. “Real-time RT-PCR in COVID-19 detection: issues affecting the results”. Expert Review of Molecular Diagnostics 5 (2020): 453-454.
  22. Chakrabarti A., et al. “Incidence, characteristics and outcome of ICU-acquired candidemia in India”. Intensive Care Medicine 41 (2015): 285-295.
  23. Clancy CJ and Nguyen MH. “Finding the “missing 50%” of invasive candidiasis: how nonculture diagnostics will improve understanding of disease spectrum and transform patient care”. Clinical Infectious Diseases 56 (2013): 1284-1292.
  24. He S., et al. “A systematic review and meta-analysis of diagnostic accuracy of serum 1,3-β-D-glucan for invasive fungal infection: focus on cutoff levels”. Journal of Microbiology, Immunology and Infection 48 (2015): 351-361.
  25. Muthu V., et al. “Definition, diagnosis, and management of COVID-19-associated pulmonary mucormycosis: Delphi consensus statement from the Fungal Infection Study Forum and Academy of Pulmonary Sciences, India”. The Lancet Infectious Diseases 9 (2022): e240-e253.
  26. Negm EM., et al. “Fungal infection profile in critically ill COVID-19 patients: a prospective study at a large teaching hospital in a middle-income country”. BMC Infectious Diseases 1 (2023): 246.
  27. Avkan-Oğuz V., et al. “Fungal colonization and infections in patients with COVID-19 in intensive care units: A real-life experience at a tertiary-care hospital”. Respiratory Medicine and Research 82 (2022): 100937.
  28. Coşkun AS and Durmaz ŞÖ. “Fungal Infections in COVID-19 Intensive Care Patients”. Polish Journal of Microbiology 3 (2021): 395-400.
  29. Ezeokoli OT., et al. “Risk factors for fungal co-infections in critically ill COVID-19 patients, focusing on immunosuppressants”. Journal of Fungi 7 (2021): 545.
  30. Casalini G., et al. “Invasive fungal infections complicating COVID-19: a narrative review”. Journal of Fungi 11 (2021): 921.
  31. Patel A., et al. “Multicenter epidemiologic study of coronavirus disease-associated mucormycosis, India”. Emerging Infectious Diseases9 (2021): 2349.

Citation

Citation: K Hima Bindu., et al. “Invasive Fungal Infections in A Teritiary ICU in Hyderabad". Acta Scientific Medical Sciences 7.9 (2022): 183-191.

Copyright

Copyright: © 2022 K Hima Bindu., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




Metrics

Acceptance rate30%
Acceptance to publication20-30 days
Impact Factor1.403

Indexed In





News and Events


  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is September 30, 2023.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of "Best Article of the Issue".
  • Welcoming Article Submission
    Acta Scientific delightfully welcomes active researchers for submission of articles towards the upcoming issue of respective journals.

Contact US