DefinePK

Abstract

Background: Healthcare-associated infections exist as major public health obstacles which result in more serious medical conditions and lengthen hospitalization time and boost healthcare expenses. Healthcare-associated infections now feature fungal infections as critical causes with special risk to immunocompromised and critically ill patients. The research investigates both the fungal causes of HAIs in a Western Uttar Pradesh tertiary care hospital and the pattern of antifungal drug susceptibility.
Methods: Cross-sectional study was conducted for a year in the Microbiology Department of a tertiary care hospital located in Teerthanker Mahaveer Medical College & Research Centre Western Uttar Pradesh India. Hospital personnel collected different types of clinical specimens such as blood samples along with urine and respiratory secretions as well as wound swabs, pus fluids and catheter tips and sterile body fluids for fungal diagnostic procedures. Three standard microbiological methods were used for their study including direct microscopy alongside Sabouraud Dextrose Agar culture and mycological techniques sugar fermentation & assimilation for Candida species and lactophenol cotton blue staining for filamentous fungi. Testing susceptibility of antifungals guidelines CLSI M44 A2 for yeast & CLSI M38 A2 for filamentous fungi were followed. The Data analysis conducted through SPSS version 27 while establishing p<0.05 as the threshold for statistical significance.
Results: Total of 521 patients were found positive out of 884 clinical samples. The most common sample types were sputum (47.22%), urine (19.36%), and bronchoalveolar lavage (17.27%). The predominant fungal isolates were Candida albicans (47.28%), Candida tropicalis (17.13%), Candida krusei (15.4%), and Aspergillus fumigatus (4.99%). Antifungal susceptibility testing revealed significant resistance to fluconazole among Candida krusei (52.11%) and Candida albicans (26.15%). Voriconazole resistance was observed in Candida tropicalis (21.52%) and Aspergillus flavus (10.0%). Mucor exhibited complete resistance to voriconazole but was susceptible to amphotericin B and posaconazole.
Conclusion: The study highlights the high burden of fungal HAIs, particularly due to Candida and Aspergillus species, with a concerning rise in antifungal resistance. The findings emphasize the need for continuous surveillance, targeted antifungal stewardship programs, and stringent infection control measures to curb the increasing prevalence of fungal HAIs in healthcare settings.