Fungal Blood Stream Infection: The Emerging Nosocomial Mayhem in Intensive Care Unit

Bloodstream infections (BSI) belong to the most detrimental healthcare associated infections (HAI) that have an impact on the treatment result of patients hospitalised to intensive care units. Recently incidence of nosocomial fungal BSI is drastically increased in ICU patients. Although Candida BSI are well studied, there is an acute lack of data relevant to other fungi from underdeveloped countries. The present study aimed to evaluate the fungal bloodstream infection (BSI) in patients admitted to an ICU at a tertiary care teaching hospital. A conventional mycological methodology was used to identify the fungal infections isolated from BSI to the species level, and their antifungal susceptibility profile was examined. Risk factors pertaining to fungal BSI were analyzed. The rate of nosocomial BSI was 1.2%. The rate of central line associated blood stream infection (CLABSI)/1000 central line days was 3.9. The rate of fungal BSI was 5.6%. Contributing factors are gender (Male), advancing age, increased hospital stays, and central venous catheterization were significantly associated with the development of nosocomial BSI. Candida spp. was the predominant pathogen. Fluconazole resistance was observed. resistant to fluconazole was found in 61.5% of Candida isolates. Fungal pathogens have emerged as important cause of nosocomial BSI. From this study, it can be concluded that Hitherto, fungal isolates, once rarely encountered like Non-albicans Candida spp., Trichosporon spp. are now common in invasive mycosis. These pathogens often demonstrate less susceptibility to antifungal drugs, hence are associated with poor/no response to therapy and therefore may present as mayhem to patients. Finally, this emerging mayhem necessitates the importance of being vigilant about predisposing factors, strict implementation of infection prevention and control and initiation of antifungal stewardship program.