Diagnostic approach of Fungal Pathogens associated with Nosocomial Infections

Abstract

Background: Hospital-acquired fungal infections continue to increase their concern levels in critically ill patients who receive treatment within intensive care units. Healthcare-acquired invasive fungal infections show increased prevalence because patients receive prolonged hospital stays while being treated with broad-spectrum antibiotics and immunosuppressive medications. The bloodstream infections develop primarily from Candida species whereas invasive pulmonary aspergillosis usually stems from Aspergillus species infections. The knowledge of fungal pathogen distribution together with their antifungal susceptibility allows optimization of patient care and antifungal resource management.

Methods: The research spanned two years at a tertiary care hospital microbiology laboratory through its entire period. The research team gathered 884 clinical samples from blood, urine, respiratory secretions and sterile body fluids which came from patients showing signs of nosocomial fungal infections. Research personnel used traditional microbial identification methods for fungal species recognition. The microbiology laboratory tested antifungal susceptibilities using the Clinical and Laboratory Standards Institute (CLSI) guidelines M44 A2 & M38 A2 to evaluate yeast and mold sensitivity by disk diffusion and broth microdilution methods. The researchers utilized SPSS version 26.0 for statistical analysis.

Results: Among 884 samples scientists recovered 521 fungal isolates which were distributed between 461 yeast isolates and 60 mould isolates. The yeast Candida albicans (47.28%) dominated among tested species followed by C. tropicalis (17.14%) as well as C. krusei (15.40%). Among the isolated moulds Aspergillus fumigatus stood as the most common species with a frequency of 43.33%. AFST demonstrated that Candida isolates showed strong reaction to amphotericin B with 100% susceptibility and voriconazole with 88.73% to 97.24% efficacy yet fluconazole sensitivity existed primarily in C. krusei (77.46%), C. glabrata (77.77%) and C. dubliniensis (62.5%).

Conclusion: Routine antifungal susceptibility tests combined with species-specific antifungal therapy have become necessary because non-albicans Candida infections and fluconazole-resistant strains are increasing. Patient outcomes will improve while nosocomial fungal infections decrease when healthcare facilities establish antifungal stewardship programs together with strict infection control measures and early diagnostic procedures