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Abstract

Introduction:

Colonisation of body surfaces with resistant strains is an initial step in the pathogenesis of drug resistant invasive infections. Nigeria has little data on the species distribution and resistance pattern of colonising species in intensive care unit(ICU) patients. This study set out to investigate the burden of colonisation in the ICU of a tertiary health institution in Ile-Ife, Nigeria.

Methodology:

At admission, 72 hours and 7 days, swabs of skin, oropharynx, perianal region, surgical wounds, tracheal aspirates and urine samples taken from adult ICU patients were cultured on media selective for fungi. species were identified by standard microbiological methods. Sensitivity to fluconazole, voriconazole and caspofungin was determined by disc diffusion according to CLSI guidelines. Strain interrelatedness was investigated by Randomly Amplified Polymorphic DNA (RAPD).

Results:

Of 744 samples from 110 patients, 142 samples (18.3%) yielded . The average colonisation index increased with duration of admission (=0.001). Most frequently colonized were the oropharynx (39.5%) and the perianal region (22.4%). Species isolated were 97 (68.3%), 20 (14.1%), 12 (8.5%), 7 (4.9%) and 6 (4.2%). About 1 in every 3 isolates was resistant to fluconazole (42/142; 29.6%). In addition, resistance to voriconazole was 12/142 (8.5%) while 10/142 (7%) were resistant to caspofungin. RAPD showed identical strains across several body sites of many patients.

Conclusion:

species with high rates of resistance to the first line antifungal agent colonise and are transmitted among ICU patients. These can potentially cause difficult to treat invasive infections, underscoring a need for better infection control practices.

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/content/journal/acmi/10.1099/acmi.byg2019.po0021
2019-11-01
2019-12-11
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