Characterization of Nosocomial Fungal Infection among Hepatic ICU Patients in National Liver Institute

Ghoneim, Enas M.; Abd ElAziz, Azza M.; Mahmoud, Eman A.; Awad, Samah M.

doi:10.21608/ejmm.2024.326097

Characterization of Nosocomial Fungal Infection among Hepatic ICU Patients in National Liver Institute

Document Type : New and original researches in the field of Microbiology.

Authors

Medical Microbiology & Immunology Department, National Liver Institute, Menoufia University

10.21608/ejmm.2024.326097

Abstract

Background: Fungi now represent a serious worldwide threat especially in patients with comorbidities as liver diseases with association of high mortality rates. Regular assessment of at-risk patients, diagnosis by reliable methods in addition to knowledge about antifungal susceptibility and possible sources of such infection help to contain the spread of those life threating infections among high-risk hepatic ICU patients. Objective: Determination of the incidence, morbidity and mortality of nosocomial fungal infection in hepatic ICU patients, determination of the possible risk factors and antifungal susceptibility pattern in them, tracing possible sources of infection and finally assessment available disinfectants against fungi. Methodology: The study was conducted on 150 hepatic ICU patients after 48^th hours from admission and also on their related environment. Fungal cultures and Multiplex PCR were done for isolation and species identification of the isolates and antifungal susceptibility and antifungal bio typing of suspected sources of infection were performed by VITEK 2 YST–AST cards and disc diffusion method different disinfectants were tested by sampling surfaces before and after disinfection. Results: The incidence of NFI among hepatic ICU patients was (23.3%) with high mortality (69%). The most significant risk factors were the presence of CVC, prolonged ICU stay, COVID infection, previous fungal colonization, antibiotics and corticosteroid exposure and total parenteral nutriton. The most predominant species were C.albicans (43%) with rising incidence of Non albicans (57%).Antifungal susceptibilities were variable with increasing incidence of Azoles resistance. HCWs hands were the most common source of infection (58%). Lysoformine and Chlorine were effective against environmental fungi (100% reduction).Conclusion: NFI are obvious threat to hepatic ICU patients with high incidence and high mortality rates which is needed to be early diagnosed specifically to species level for proper antifungal targeting. Proper hand hygiene and environmental cleaning are the corner stone of prevention.

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