ABSTRACT
Introduction: Candida auris has been reported from various health care settings and has recently gained importance because of its intrinsic resistance to many classes of antifungal agents and to disinfection. The outbreak potential and high mortality associated with Candida auris infection reinforces the need for speciation. Routine conventional methods are cumbersome and automated systems are unable to confirm up to species level. Materials and Methods: Candida auris isolates from consecutive non-repetitive blood cultures over a 1-year period were speciated based on phenotypic, physiological and biochemical tests and VITEK. Molecular confirmation was done by PCR-RFLP and MALDI-TOF. Anti- fungal susceptibility test was performed according to CLSI guidelines (2021), using suitable controls. Virulence factors such as production of Hemolysin, Phospholipase, Esterase and Bio-film production were demonstrated. RT-PCR was used to screen the COVID-19 status using SD-Biosensor kit. Baseline data and clinical history were collected and analysed. Results: Of 3632 blood cultures (0.77%), 28 Candida sp. were isolated including 9 Candida auris, (9/28, 32.14%). Of these 8 were from COVID-19 positive patients (88.89%), while 1 was from COVID-19 negative patient (11.11%). Two patients survived, while the remaining 7 patients succumbed to the disease. Conclusion: The increasing incidence of Candidiasis especially during the COVID-19 pandemic has raised the concern for early speciation. Through multi-modal strategies such as quick and correct identification, active surveillance, guided reporting, stringent infection control measures and correct use of anti-fungals through proper susceptibility testing, we can prevent the occurrence and spread of new Candida auris cases in the future.
ABSTRACT
Introduction: Secondary bacterial infections have been reported in majority of patients hospitalized with coronavirus disease 2019 (COVID-19). A study of the antimicrobial susceptibility profiles of these bacterial strains revealed that they were multidrug resistant, demonstrating their resistance to at least three classes of antimicrobial agents including beta-lactams, fluoroquinolones and aminoglycosides. Bacterial co-infection remains as an important cause for high mortality in patients hospitalized with COVID-19. Methods: In our study, we conducted a retrospective comparative analysis of bacterial co-infections and the antimicrobial resistance profile of bacterial isolates obtained from inpatients admitted in COVID-19 and non-COVID-19 intensive care units. The goal was to obtain the etiology and antimicrobial resistance of these infections for more accurate use of antimicrobials in clinical settings. This study involved a total of 648 samples collected from 356 COVID-19 positive patients and 292 COVID-19 negative patients admitted in the intensive care unit over a period of six months from May to October 2020. Results: Among the co-infections found, maximum antimicrobial resistance was found in Acinetobacter species followed by Klebsiella species in both the ICU's. Incidence of bacterial co-infection was found to be higher in COVID-19 intensive care patients and most of these isolates were multidrug resistant strains. Conclusion: Therefore, it is important that co-infections should not be underestimated and instead be made part of an integrated plan to limit the global burden of morbidity and mortality during the SARS-CoV-2 pandemic and beyond.