Invasive Fungal Disease in an Intensive Care Unit of Tertiary Care Hospital of Bangladesh

Background: Invasive fungal infections (IFIs) represent a major challenge in intensive care units (ICUs) globally, contributing significantly to morbidity and mortality among critically ill patients. It is crucial to comprehend the dynamics of these infections in Bangladesh, considering its unique healthcare environment and tropical climate, to enhance management and prevention strategies effectively. Materials and Methods: The study was designed as a retrospective cohort study. Data was collected from fungal surveillance database of non-covid ICU of Dhaka Medical college for a period ranging from July 2022 to April 2024. The study enrolled 205 patients based on specific criteria. It aimed to identify the prevalence & resistance pattern of invasive fungal species. Statistical Package for Social Science (SPSS) version 25.0 was used for data analysis. Results: In the study of 205 ICU patients, demographic analysis revealed a predominance of males (65.37%) and an age distribution skewed towards those aged 30-60 years (46.34%). Common comorbidities included diabetes (20.00%), hypertension (24.88%), chronic kidney disease (10.24%), and COPD (14.63%). Invasive procedures, such as central venous lines (44.88%), were prevalent, alongside notable rates of fungal infection (8.29%), primarily involving Candida species. Resistance patterns among fungal-positive blood samples showed significant resistance to Amphotericin B, Caspofungin, and Voriconazole (50% each), while Fluconazole and Flucytosine exhibited no resistance. Species analysis identified Candida albicans, Candida tropicalis, and Candida auris with varying mortality rates (100%, 80%, and 66.67%, respectively). Conclusion: High mortality rates associated with Candida species underscore the urgent need for effective antifungal strategies tailored to local resistance patterns. Continued surveillance and improvements in infection prevention and control measures are essential to mitigate the impact of emerging resistant pathogens like Candida auris in healthcare settings.