Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Sep;67(9):e13790.
doi: 10.1111/myc.13790.

Candidaemia and Central Line-Associated Candidaemia in a Network of Indian ICUs: Impact of COVID-19 Pandemic

Purva Mathur  1 , Sharad Srivastav  1 , Arpan Kumar Thakur  1 , Rasna Parveen  1 , Mamta Puraswani  1 , Ashish Kumar Srivastava  1 , Arunaloke Chakrabarti  2 , Camilla Rodrigues  3 , Veeraraghavan Balaji  4 , Pallab Ray  2 , Manisha Biswal  2 , Chand Wattal  5 , Vimala Venkatesh  6 , Nandini Sethuraman  7 , Sanjay Bhattacharya  8 , Vijaya Lakshmi Nag  9 , Vibhor Tak  9 , Bijayini Behera  10 , Neeraj Goel  5 , Jyoti Iravane  11 , Sudipta Mukherjee  12 , Raja Ray  13 , Sanjeev K Singh  14 , Chiranjay Mukhopadhyay  15 , Joy Sarojini Michael  4 , Bashir Ahmad Fomda  16 , Juliah Chelliah  3 , Anjali Shetty  3 , Tadepalli Karuna  17 , Aparna Ningombam  1 , Subodh Kumar  18 , Kapil Dev Soni  19 , Sushma Sagar  18 , Richa Aggrawal  19 , Deepak Gupta  20 , Gyaninder Pal Singh  21 , Ashish Bindra  21 , Kamran Farooque  22 , Shashank Purwar  17 , Sagar Khadanga  23 , K E Vandana  15 , Muralidhar Varma  24 , Vijayshri Deotale  25 , Padma Das  26 , Ruchita Lohiya  25 , Amber Prasad  27 , Puneet Kumar Gupta  27 , Balram Ji Omar  27 , Ankit Aggarwal  28 , Sherish Baqal  16 , Khuraijam Ranjana Devi  29 , L Chaoba Singh  30 , Soumyadip Chatterji  31 , Gaurav Goel  8 , Satyam Mukherjee  8 , Yamunadevi V Ramanathan  7 , Aparna Sonowal  32 , Prachi Verma  33 , Ashoka Mahapatra  10 , Vinaykumar Hallur  10 , Ujjwala Nitin Gaikwad  26 , Anudita Bhargava  26 , Kanne Padmaja  34 , Nagari Bheerappa  35 , Vidhi Jain  9 , Pradeep Bhatia  36 , Kuldeep Singh  37 , Daisy Khera  37 , Neeraj Gupta  38 , Hema Paul  4 , Sheetal Verma  6 , Zia Arshad  39 , Ratinder Jhaj  40 , Shikha Malik  41 , M A Thirunarayan  7 , Hirak Jyoti Raj  13 , Prashant Gupta  6 , Dandu Himanshu  42 , Shivaprakash M Rudramurthy  2 , Reema Nath  32 , Renu Gur  43 , Nari M Lyngdoh  44 , Clarissa Lyngdoh  45 , Sheela Devi  46 , Shalini Malhotra  47 , Rajni Gaind  48 , Rushika Saksena  48 , Rajni Sharma  49 , Kamini Walia  50
Affiliations

Candidaemia and Central Line-Associated Candidaemia in a Network of Indian ICUs: Impact of COVID-19 Pandemic

Purva Mathur et al. Mycoses. 2024 Sep.

Abstract

Background and objectives: Candidaemia is a potentially life-threatening emergency in the intensive care units (ICUs). Surveillance using common protocols in a large network of hospitals would give meaningful estimates of the burden of candidaemia and central line associated candidaemia in low resource settings. We undertook this study to understand the burden and epidemiology of candidaemia in multiple ICUs of India, leveraging the previously established healthcare-associated infections (HAI) surveillance network. Our aim was also to assess the impact that the pandemic of COVID-19 had on the rates and associated mortality of candidaemia.

Methods: This study included adult patients from 67 Indian ICUs in the AIIMS-HAI surveillance network that conducted BSI surveillance in COVID-19 and non-COVID-19 ICUs during and before the COVID-19 pandemic periods. Hospitals identified healthcare-associated candidaemia and central line associated candidaemia and reported clinical and microbiological data to the network as per established and previously published protocols.

Results: A total of 401,601 patient days and 126,051 central line days were reported during the study period. A total of 377 events of candidaemia were recorded. The overall rate of candidaemia in our network was 0.93/1000 patient days. The rate of candidaemia in COVID-19 ICUs (2.52/1000 patient days) was significantly higher than in non-COVID-19 ICUs (1.05/patient days) during the pandemic period. The rate of central line associated candidaemia in COVID-19 ICUs (4.53/1000 central line days) was also significantly higher than in non-COVID-19 ICUs (1.73/1000 central line days) during the pandemic period. Mortality in COVID-19 ICUs associated with candidaemia (61%) was higher than that in non-COVID-19 ICUs (41%). A total of 435 Candida spp. were isolated. C. tropicalis (26.7%) was the most common species. C. auris accounted for 17.5% of all isolates and had a high mortality.

Conclusion: Patients in ICUs with COVID-19 infections have a much higher risk of candidaemia, CLAC and its associated mortality. Network level data helps in understanding the true burden of candidaemia and will help in framing infection control policies for the country.

Keywords: COVID‐19; ICUs; India; bloodstream infections; candidaemia; central line associated candidaemia (CLA‐candidaemia); healthcare associated infections; surveillance.

PubMed Disclaimer

References

    1. R. M. Ribas, C. Freitas, and P. P. Gontijo Filho, “Nosocomial Bloodstream Infections: Organisms, Risk Factors and Resistant Phenotypes in the Brazilian University Hospital,” Brazilian Journal of Infectious Diseases 11 (2007): 351–354.
    1. A. G. Barnett, K. Page, M. Campbell, et al., “The Increased Risks of Death and Extra Lengths of Hospital and ICU Stay From Hospital‐Acquired Bloodstream Infections: A Case–Control Study,” BMJ Open 3, no. 10 (2013): e003587.
    1. M. Ishikane, K. Hayakawa, S. Kutsuna, N. Takeshita, and N. Ohmagari, “Epidemiology of Blood Stream Infection due to Candida Species in a Tertiary Care Hospital in Japan Over 12 Years: Importance of Peripheral Line‐Associated Candidemia,” PLoS One 11, no. 10 (2016): e0165346.
    1. Y. C. Chen, M. W. Ho, W. C. Chao, and C. C. Chang, “Different Epidemiological Characteristics Between Patients With Non‐Hospital‐Onset and Hospital‐Onset Candidemia: A Retrospective Cohort Study,” Epidemiology and Infection 9, no. 151 (2023): e102, https://doi.org/10.1017/S0950268823000894.
    1. W. Zhang, X. Song, H. Wu, and R. Zheng, “Epidemiology, Species Distribution, and Predictive Factors for Mortality of Candidemia in Adult Surgical Patients,” BMC Infectious Diseases 20, no. 1 (2020): 506, https://doi.org/10.1186/s12879‐020‐05238‐6.

LinkOut - more resources