International Journal of Research in Medical Sciences | April 2019 | Vol 7 | Issue 4 Page 1184 International Journal of Research in Medical Sciences Sandhu R et al. Int J Res Med Sci. 2019 Apr;7(4):1184-1189 www.msjonline.org pISSN 2320-6071 | eISSN 2320-6012 Original Research Article Candida tropicalis: insight into the characteristics and outcome of adult patients admitted in medical and surgical intensive care units Raminder Sandhu 1 *, Ramnika Aggarwal 2 , Surinder Kumar 1 , Diksha Budhani 1 INTRODUCTION The presence of infection in critically ill patients poses unique challenges as it can directly influence the morbidity and mortality. Of the various infections prevalent in an intensive care unit, invasive fungal infection has always been considered to occur infrequently, but, over the past few years, with the surge in broad-spectrum antibiotic usage and improved knowledge of fungal diseases, the incidence has risen. At present, systemic fungal infections constitute a major problem in intensive care units in both developed and developing nations. However, intensivists in tropical developing countries like India face an uphill task during management of this ever increasing menace of fungal infections. 1 Over the last three decades, Candida species has emerged as an important cause of health care associated and opportunistic infections. Although most 1 Department of Microbiology, BPS GMC for Women, Khanpur Kalan, Sonepat, Haryana, India 2 Department of Community Medicine, Kalpana Chawla Govt. Medical College, Karnal, Haryana, India Received: 18 December 2018 Accepted: 01 March 2019 *Correspondence: Dr. Raminder Sandhu, E-mail: sandhuraminder19@yahoo.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACT Background: Non albicans species are emerging increasingly as significant ICU pathogens. The increasing incidence of C. tropicalis infections is a significant problem because of its ability to develop rapid resistance to fluconazole. Methods: The study was designed to isolate, evaluate the risk factors and outcome of C. tropicalis infection from intensive care units. Identification was done by the biochemical methods. A total of 89 patients culture positive for C. tropicalis were selected for retrospective analysis over a period of one year. We collected various data about risk factors and outcome from the medical records. Results: A total of 89 patients culture positive for Candida tropicalis were analysed. Majority of these culture isolates were obtained from their blood (59.55%) followed by urine samples (31.46%). The indwelling devices (93.2%) remained a highest risk followed by prolonged administration of antibiotic therapy (92.1%) and admission in ICU for more than a week (88.8%). Overall mortality rate was 31.5%. Mortality was higher in patients with longer total length of stay in hospital (89.3%; p 1.000), indwelling devices (85.7%; p 0.5663) and in whom the antimicrobial therapy was administered for prolonged duration (82.1%; p 0.7581), although these factors remained statistically insignificant. 92.1% of isolates were sensitive to amphotericin B and showed 52.8%; 9.0% sensitivity to itraconazole and fluconazole respectively. Conclusions: C. tropicalis is now classified as the third or fourth NAC species being commonly isolated from clinical samples and associated with persistent systemic infections leading to a longer stay in the hospital. Several virulence factors seem to be responsible for high dissemination and mortality. Keywords: Candidemia, C. tropicalis, ICU, Risk factors DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20191322