Affiliation:
1. Assistant Professor of Microbiology, Government Medical College & ESI Hospital, Coimbatore, Tamil Nadu.
2. Associate Professor of Microbiology, Government Villupuram Medical College, Villupuram, Tamil Nadu.
3. Former Director and Professor of Microbiology, Institute of Microbiology, Madras Medical College & RGGGH, Chennai, Tamil Nadu.
Abstract
Patients undergoing Hemodialysis in Renal failure cases are at a higher risk of developing pathogenic and opportunistic fungal infections and
parasitic infections due to the defective immune system. Accumulation of non excreted metabolites by kidney and associated chronic renal
insufciency leads to uremia and induces a state of immunosuppression that results in higher frequency of acquiring fungal and parasitic infection
through Central venous catheters (CVC), contact with nursing personale, equipments, material on surface and from hands. Opportunistic intestinal
parasitic infections are the most important cause of severe diarrhea in immunocompromised individuals, especially in patients undergoing
hemodialysis. This cross sectional study was undertaken to determine the incidence of fungal and parasitic infection in Acute and Chronic Renal
failure patients on hemodialysis with Central Venous Catheter, to analyze the associated risk factors and to perform antifungal susceptibility
pattern. This study was done in the Institute of Microbiology in association with Department of Nephrology, Madras Medical College, Rajiv
Gandhi Government General Hospital, and Chennai for a period of one year from September 2011- October 2012 A total Materials and Methods:
number of 150 inpatients between the age group of 18-65 who are admitted for Hemodialysis in Nephrology ward were taken for the study. The risk
factors associated in developing fungal and parasitic infections were observed. Fungal isolates from Blood, Catheter tip, swab from infected site,
urine, Sputum were cultured by fungal culture and isolation of parasites in stool sample was done according to standard microbiological
techniques. Antifungal susceptibility testing was done using standard CLSI guidelines. A total of 5.6% of C.albicans, C.tropicalis, Results:
C.parapsilosis was isolated from blood. Aspergillus avus was isolated only from catheter in 11.1% of cases and Aspergillus fumigatus in 5.6% of
cases. Among the 4 cases Candida species isolated from catheter, 3 cases had candidemia and was treated with intravenous antifungal drugs. Out
of 150 patients 13 patients had gastero intestinal symtoms Entamoeba histolytica was predominantly seen in 46.1% of patients with
gasterointestinal symptoms followed by Giardia 30.7% , Cryptosporidium parvum 15.3% and Microsporidia 7.6%
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