Garima Gautam^*

Department of Microbiology, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India

Correspondence to: Garima Gautam, Department of Microbiology, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India. E-mail: garima_gautam1920@gmail.com

Received: February 19, 2023; Accepted: March 12, 2023; Published: March 20, 2023

Citation: Gautam G. Candidemia in Hematological Patients: A Hospital-Based Study Among Adults in Northern India. J Immunol Microbiol. 2023;1(1):06-10.

Copyright: © 2023 Gautam G. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

ABSTRACT

Background: Candidemia has emerged as a prevalent fungal bloodstream infection globally, particularly impacting individuals with hematological malignancies who face heightened morbidity and mortality. The objective of this study is to achieve early diagnosis and precise identification of Candida species in hematological patients.

Methods: We conducted a study spanning from November 2018 to April 2022, enrolling patients with hematological malignancies. Diagnostic approaches included conventional methods, antigen detection, and PCR for early detection of Candidemia. A comparison of conventional, automated, antigen detection, and PCR methods was performed for diagnosis, followed by antifungal susceptibility testing for treatment guidance in hematological patients.

Results: A total of 229 patients with febrile neutropenia were enrolled, comprising 152 males (66.37%) and 77 females (33.62%), with ages ranging from 10 to 77 years (Mean=33.65, Standard deviation=16.40). The prevalence of Candidemia was 2.1% in this study. Blood culture identified Candidemia in five patients (2.6%), while PCR detected it in nine patients (4.8%). Among the four patients with acute myeloid leukemia (AML), Candida tropicalis (3; 1.60%) and Candida auris (1; 0.5%) were prevalent, alongside one case of pancytopenia with Candida tropicalis (1; 0.5%).

Conclusion: This observational study underscores the significant association between Candidemia and hematological malignancies. Automated diagnostic methods demonstrate higher sensitivity and specificity for species identification. The integration of non-culture methods such as PCR and mannan antigen detection into routine laboratory practices holds promise for early diagnosis and improved treatment outcomes in Candidemia infections.

Keywords: Candidemia; Diagnosis; Hematological Patients; Polymerase Chain Reaction; Treatment.

ABBREVIATIONS

PCR: Polymerase Chain Reaction; Mn: Mannan antigen; A-Mn: Anti-Mannan antibodies; ECIL: European Conference on Infections in Leukemia; DMSO: Dimethyl Sulfoxide; MALDI-TOF: Matrix-Assisted Laser Desorption/Ionization; CLSI: Clinical Laboratory Standards Institute.