Project Description

Author: Hasan et al.


Background: Invasive fungal infections are a growing problem in critically ill patients and are associated with increased morbidity and mortality. It can causes candidemia, disseminated candidiasis with deep organ involvement and chronic disseminated candidiasis. Along with the traditional candida species, rare pathogenic fungi are also emerging. Timely diagnosis and proper treatment are of paramount importance for a favorable outcome. The aim of the study is to determine the contemporary epidemiology, management, and outcome of invasive fungal infections in critically ill patients admitted in ICU. Patients and Methods: This prospective surveillance study will be performed in three ICU departments at Dhaka Medical College Hospital, Sir Salimullah Medical College Mitford Hospital and Mugda Medical College Hospital from January 1 to December 31, 2018. All patients above 18 years of age in whom fungal infection or colonization will be confirmed by specimen culture will be included in the study. Before starting the study ethical permission will be taken from ethical review committee of the 3 centers. Informed consents will be obtained from the patients or surrogate decision makers. For each of the cases, demographic and clinical data (age, gender, comorbidities, risk factors, clinical presentations, severity of illness on ICU admission, organ dysfunctions on enrollment, length of stay, concomitant bacterial infections and antibiotic therapy, antifungal prophylaxis and treatment) will be collected. Severity on admission will be defined by the APACHE II score and organ dysfunction will be computed by the Sequential Organ Failure Assessment (SOFA) score. Microbiological data (e.g., etiological agents, fungal colonization antifungal susceptibility) will be noted then. All biological samples will be cultured on Sabouraud’s dextrose agar (SDA) and relevant investigations will be done. Culture facility will be availed from Infectious Disease Hospital, Dhaka. Primary outcome will be assessed by ICU mortality. Other assessed outcomes will be length of stay in the ICU, and duration of mechanical ventilation. Collected data will be recorded into separate case record forms, and finally, the analysis will be performed using SPSS 23. Conclusion: It is expected that the study will give us a fair knowledge about local epidemiologic trend and evidence based management protocol on invasive fungal infection in critically ill patients.

Status: Ongoing

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