Spectrum of fungal infection in pulmonary intensive care unit of Menoufia University Hospital

• Published in: The Egyptian journal of chest diseases and tuberculosis Vol. 68; no. 3; pp. 356 - 362
• Main Authors: Mansour, Osama, El Wahsh, Rabab, El Dahdouh, Samy, Salem, Eman, El Sharkawy, Dalia
• Format: Journal Article
• Language: English
• Published: Wolters Kluwer India Pvt. Ltd 01.07.2019; Wolters Kluwer Medknow Publications
• Subjects: aspergillus and candida; fungal infection; pulmonary ICU; aspergillus and candida; pulmonary ICU; fungal infection
• ISSN: 0422-7638; 2090-9950
• DOI: 10.4103/ejcdt.ejcdt_3_19

Background Invasive fungal infections are on the increase not only among oncology and transplant patients but also among patients admitted to the ICU. Aimof the study The aim is to assess and evaluate the spectrum of respiratory fungal infection in pulmonary ICU. Patients and methods This observational cohort study was carried out on 80 patients admitted in the respiratory ICU of Menoufia University Hospital in the period from January to October 2017. All patients were subjected to fungal culture of sputum or tracheal aspirate, and blood culture in cases of suspected fungemia. All samples were cultured on Sabouraud dextrose agars. Results Of the patients (80), there were 34 (42.5%) patients with positive [13 (16.25%) with positive candida, 15 (18.75%) with positive aspergillus, six (7.5%) with mixed (candida+aspergillus)], and 46 (57.5%) with negative sputum and endotracheal aspirate fungal culture. There was significant statistical difference between sputum fungal culture results regarding the duration of invasive mechanical ventilation and ICU stay duration (P=0.001 for both). Six out of 35 blood fungal culture were positive for aspergillus, while there was no positive blood fungal culture for candida. These six patients were positive in both sputum and blood fungal cultures (aspergillus), three of them were pneumonia patients, one had lung abscess, one had chronic obstructive pulmonary disease and bronchiectasis and one was bronchogenic carcinoma patient. There were significant statistical differences between blood fungal culture results regarding ICU stay duration and body temperature (P=0.028 and 0.005, respectively). Conclusion Fungal infection is an important problem in pulmonary ICU patients, with no typical clinical picture or specific radiographic findings. Candida and aspergillus are the only fungal pathogens that were isolated from the lower respiratory tract samples of pulmonary ICU patients in Menoufia University Hospital.