scholarly journals Spectrum of Opportunistic Fungal Infections in HIV/AIDS Patients in Tertiary Care Hospital in India

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Ravinder Kaur ◽  
Megh S. Dhakad ◽  
Ritu Goyal ◽  
Preena Bhalla ◽  
Richa Dewan
Keyword(s):  
Fungal Infections ◽  
Tertiary Care ◽  
North India ◽  
Clinical Samples ◽  
Fungal Culture ◽  
Care Hospital ◽  
Aids Patients ◽  
Cell Counts ◽  
Fungal Isolates ◽  
Hiv Aids

HIV related opportunistic fungal infections (OFIs) continue to cause morbidity and mortality in HIV infected patients. The objective for this prospective study is to elucidate the prevalence and spectrum of common OFIs in HIV/AIDS patients in north India. Relevant clinical samples were collected from symptomatic HIV positive patients (n=280) of all age groups and both sexes and subjected to direct microscopy and fungal culture. Identification as well as speciation of the fungal isolates was done as per the standard recommended methods. CD4+T cell counts were determined by flow cytometry using Fluorescent Activated Cell Sorter Count system. 215 fungal isolates were isolated with the isolation rate of 41.1%.Candidaspecies (86.5%) were the commonest followed byAspergillus(6.5%),Cryptococcus(3.3%),Penicillium(1.9%), andAlternariaandRhodotorulaspp. (0.9% each). AmongCandidaspecies,Candida albicans(75.8%) was the most prevalent species followed byC. tropicalis(9.7%),C. krusei(6.4%),C. glabrata(4.3%),C. parapsilosis(2.7%), andC. kefyr(1.1%). Study demonstrates that the oropharyngeal candidiasis is the commonest among different OFIs and would help to increase the awareness of clinicians in diagnosis and early treatment of these infections helping in the proper management of the patients especially in resource limited countries like ours.

scholarly journals Mycological Pattern of Dermatomycoses in a Tertiary Care Hospital

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Ravinder Kaur ◽  
Pragyan Swagatika Panda ◽  
Kabir Sardana ◽  
Sahanawaj Khan
Keyword(s):  
Trichophyton Rubrum ◽  
Fungal Infections ◽  
Indian Subcontinent ◽  
Tertiary Care ◽  
North India ◽  
Clinical Samples ◽  
Care Hospital ◽  
Disease Occurrence ◽  
Normal Laboratory

Background. Dermatomycoses are not diseases requiring compulsory notifications; rather they cause cosmetic defacements. Indian subcontinent with a varied topography is favorable for various fungal infections.Objective. To look for the epidemiological and mycological profile of superficial mycoses in North India.Methods. Three hundred and fifty-one clinical samples of skin, hair, and nail were examined to find the fungal etiology of the dermatomycoses.Results. Dermatomycoses were seen in 215/351 (61.2%) of cases. Most common isolates obtained were nondermatophyte molds (NDMs) (36.1%), followed by dermatophytes (13.8%) and yeasts (8.6%).Aspergillus niger(9%) was the most common mold.Trichophyton rubrum(4.6%) was the most common dermatophyte isolated, while amongst the yeastsNon-albicans Candida(NAC) species were more common (6%). Many other NDMs likeSyncephalastrumspp.,Cunninghamellaspp.,Rhodotorulaspp.,A. terreus, Scytalidiumspp. andScopulariopsisspp. were also isolated.Conclusion. Our study reflects an increasing role of NDMs (thought to be normal laboratory or environmental contaminants) as a causative agent of dermatomycoses, replacing the dermatophytes. Clinician’s awareness of the demographic profile of the population involved along with more studies on dermatomycoses can help in understanding the etiological profile in area, leading to prevention of disease occurrence and cosmetic disfigurement.

scholarly journals AIDS-related opportunistic mycoses seen in a tertiary care hospital in North India

2007 ◽  
Vol 56 (8) ◽  
pp. 1101-1106 ◽  
Author(s):  
Anupriya Wadhwa ◽  
Ravinder Kaur ◽  
Satish Kumar Agarwal ◽  
Shyama Jain ◽  
Preena Bhalla
Keyword(s):  
Fungal Infections ◽  
Tertiary Care ◽  
Small Sample ◽  
North India ◽  
World Health ◽  
Fungal Culture ◽  
Care Hospital ◽  
Female Ratio ◽  
Cd4 Counts ◽  
Common Diagnosis

Sixty symptomatic confirmed human immunodeficiency virus (HIV)-positive adult patients, of both sexes, suspected of having a fungal infection were taken as a study population, and the clinicomycological profile was correlated with the immunological status of the patients with particular reference to CD4 counts. Relevant samples were collected and subjected to direct microscopy, fungal culture and serology. CD4 counts were determined by flow cytometry. Patients belonged to the age group of 17–65 years, with a male : female ratio of 4.8 : 1. Heterosexuality was the commonest mode of transmission. Candidiasis was the most common diagnosis (41.7 %), followed by cryptococcosis (10.0 %), and pneumocystinosis and aspergillosis (8.3 % each). Two cases of histoplasmosis were also diagnosed. A low mean CD4 count of <200 cells μl−1 was seen with most fungal infections. A total of 73 % of patients belonged to World Health Organization (WHO) stage 4, while 23.33 % belonged to stage 3. Thirty one patients (51.67 %) belonged to Centers for Disease Control and Prevention (CDC) stage C3. Various fungal infections correlated well with the mean CD4 counts. It was difficult to correlate statistically WHO and CDC staging because of the small sample size. However, it was possible to assess to a limited extent the possibility of using clinical diagnosis to predict the status of progression of HIV infection in a resource-poor outpatient setting.

scholarly journals Epidemiological profile of candidiasis in HIV/AIDS patients in a tertiary care hospital

2020 ◽  
Vol 7 (12) ◽  
pp. 4858
Author(s):  
Megh S. Dhakad ◽  
Ravinder Kaur ◽  
Ritu Goyal ◽  
Preena Bhalla ◽  
Richa Dewan
Keyword(s):  
Fungal Infections ◽  
Oral Candidiasis ◽  
Tertiary Care ◽  
Cd4 Count ◽  
Clinical Samples ◽  
Care Hospital ◽  
Cd4 Counts ◽  
Epidemiological Profile ◽  
Loss Of Appetite ◽  
Hiv Aids

Background: Clinical research in fungal infections is largely a neglected area in health care settings in India. Candida species cause diseases ranging from mucosal infections to systemic mycoses depending on host’s immune status. Aim of this study was to evaluate the clinico-epidemiological profile of candidiasis, and their correlation with an immunological profile in HIV/AIDS patients.Methods: Clinical details and investigations of 200 symptomatic, confirmed HIV-positive patients, suspected of having candidiasis were recorded and analyzed. Relevant clinical samples depending on the organ system involved were collected and subjected to direct microscopy, culture isolation and serology. Identification and speciation of the isolates was done by biochemical methods as per standard recommended procedures. CD4-count was determined by flow cytometry using Fluorescent Activated Cell Sorter Count system.Results: Patients ranged from 17-65 years with a mean age of 33.83±9.07 years. Most common clinical presentations were seen to be white oral patches (82%), weight loss (79%), fever (67%), loss of appetite (53%), headache (51.5%), cough (38.5%) and diarrhea (30%).  Gastrointestinal system (35%) was the most commonly involved system. The CD4-counts ranged from 16-1033 cells/μl. 93 (46.5%) patients had CD4-counts <200 cells/μl, while CD4-count <100 cells/μl was seen in 40 (20%) and CD4-count <50 cells/μl in 20 (10%). Candidiasis was detected in 60% of the patients. Yeasts isolated were C. albicans (82.51%), C. tropicalis (6.29%), C. krusei (4.89%), C. parapsilosis (3.49%), and C. glabrata (2.79%).Conclusions: C. albicans was predominant species and presence of oral candidiasis is a matter of concern. Early and accurate diagnosis of candidiasis is one of the keys helps for the success of effective HIV/AIDS disease management. 

scholarly journals Epidemiological characterization of dermatophytes at a tertiary care hospital in Eastern Uttar Pradesh, India

2019 ◽  
Author(s):  
Ankur Kumar ◽  
Vandana Upadhyay ◽  
Amresh K. Singh ◽  
Jayesh Pandey
Keyword(s):  
Low Socioeconomic Status ◽  
Fungal Infections ◽  
Tertiary Care ◽  
Uttar Pradesh ◽  
Common Species ◽  
Personal Hygiene ◽  
Clinical Samples ◽  
Care Hospital ◽  
Direct Microscopic Examination ◽  
Superficial Mycosis

Background and Purpose: Superficial mycosis is more prevalent in tropical and subtropical countries, such as India. Regarding this, the present study was conducted to determine the epidemiology of superficial mycosis and identify the most common dermatophytic species in this region. Materials and Methods: For the purpose of the study, a total of 220 skin scraping, nail, and hair root specimens were collected. Direct microscopic examination was performed using potassium hydroxide mount. Additionally, the samples were inoculated onto Sabouraud dextrose agar (SDA) and dermatophyte test medium (DTM). The fungal colony of each isolates was stained with lactophenol cotton blue mount, and observed under microscope for species identification. Results: Out of 220 isolates, 172 samples, obtained from 108 males 64 females, were positive for skin fungal infections by either KOH mount or culture. Furthermore, 113 isolates were identified as dermatophytes, while 59 samples were found to be non-dermatophytes. Among the dermatophytes isolated from different clinical samples, Trichophyton verrucosum (42/113, 38%) was the most common species, and Tinea corporis was the most common infection (36.2%). Conclusion: As the findings indicated, dermatophytes had an isolation rate of 78%, which is higher than normal. This can be due to the fact that the majority of the patients were from a rural background (71.7%) with a low socioeconomic status and poor personal hygiene who were exposed to climatic changes.

scholarly journals Immunologic biomarkers, morbidity and mortality among HIV patients hospitalised in a Tertiary Care Hospital in the Brazilian Amazon

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wellington Mota Gama ◽  
Carlos Henrique Michiles Frank ◽  
Taynná Vernalha Rocha Almeida ◽  
Daniel Silva dos Santos ◽  
Yury Oliveira Chaves ◽  
...  
Keyword(s):  
Platelet Activation ◽  
Opportunistic Infections ◽  
Tertiary Care ◽  
Enzyme Linked Immunosorbent Assay ◽  
People Living With Hiv ◽  
Care Hospital ◽  
Aids Patients ◽  
Distribution Width ◽  
Advanced Immunosuppression ◽  
Hiv Aids

Abstract Background The irregular use of antiretroviral therapy (ART) and late diagnosis still account for a large part of HIV-associated mortality in people living with HIV (PLHIV). Herein, we describe HIV-associated morbidity among hospitalised HIV/AIDS patients with advanced immunosuppression and assess the comorbidities, laboratory parameters, and immunological markers associated with mortality. Methods The cross-sectional study was conducted at the Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD) in Manaus, Brazil. In all, 83 participants aged between 12 and 70 years were enrolled by convenience within 72 h of their hospitalisation. Clinical and laboratory data were obtained from electronic medical records. We prospectively measured the cytokines Th1/Th2/Th17 and inflammatory cytokines IL-8, IL-1β, and IL-12 using cytometric bead array, and the soluble CD14 using in-house enzyme-linked immunosorbent assay. Results The HIV/AIDS inpatients presented a scenario of respiratory syndromes as the most prevalent comorbidity. Almost all patients had CD4 T counts below 350 cells/mL and the mortality rate was 20.5%. Pulmonary tuberculosis, neurotoxoplasmosis and oropharyngeal–esophageal candidiasis were the most prevalent opportunistic infections. TB and weight loss were more prevalent in HIV/AIDS inpatients who died. The Mann Whitney analysis showed that those who died had higher platelet distribution width (PDW) on admission, which is suggestive for platelet activation. The Poisson multivariate analysis showed the prevalence of TB, digestive syndrome and increases in IL-8 and lactate dehydrogenase (LDH) associated to death. Conclusions The advanced immunosuppression characterized by the opportunistic infections presented in these HIV/AIDS inpatients was the major factor of mortality. The role of platelet activation in worse outcomes of hospitalisation and the IL-8 associated with the context of advanced immunosuppression may be promising markers in the prediction of mortality in HIV/AIDS patients.

scholarly journals KNOWLEDGE, ATTITUDE AND PRACTICES AMONG NURSES TOWARDS HIV/ AIDS PATIENTS IN TERTIARY CARE HOSPITAL, AMROHA

2021 ◽  
Vol 5 (2) ◽  
Author(s):  
Atul Agrawal ◽  
Ankita Agrawal
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
People Living With Hiv ◽  
Care Hospital ◽  
Aids Patients ◽  
Attitudes And Practices ◽  
Positive Attitudes ◽  
High Level ◽  
Living With Hiv ◽  
Hiv Aids

Background: Human Immunodeficiency Virus (HIV) has become one of the most serious challenges to public health due to its high morbidity, mortality and economic impacts. Good Knowledge, positive attitudes and practices are important aspects of providing nursing care for people living with HIV/AIDS. Aim: This study aimed to assess knowledge, attitudes and practices of nurses working with HIV/AIDS patients. Methods: This study was descriptive, performed on 200 nurses working with HIV/AIDS patients at a tertiary care Hospital, Amroha. Data was collected using pretested, validated, self administered questionnaire consisting of knowledge, attitude and practice based questions related to HIV/Aids and infected patients along with demographic variables of nursing staff under study.  Results: The result of this study showed that majority of nurses (81%) working with HIV/AIDS patients possess adequate level of knowledge. Most of the nurses under study showed high level of empathic attitude toward people living with HIV/AIDS (above 80%) but at the same time high level of avoidance was observed among some nurses. Practice of nurses working with HIV/AIDS patients was found good. Conclusions: There was satisfactory knowledge, positive attitudes and good practice level among nurses under study. Recommendations: Training should focus on Preventive methods and modes of HIV transmission, care and support of all patients no matter what the disease, emphasizing confidentiality as a patient right that should not be ignored and should train nurses and monitor nursing skills. Keywords: Public health, Nurses, HIV, Knowledge, Attitude, Practices

scholarly journals Immunologic Biomarkers, Morbidity and Mortality Among HIV Patients Hospitalized in a Tertiary Care Hospital in the Brazilian Amazon

2020 ◽  
Author(s):  
Wellington Gama Mota ◽  
Taynná Vernalha Rocha Almeida ◽  
Daniel Silva dos Santos ◽  
Yury Oliveira Chaves ◽  
Danielle Furtado da Silva ◽  
...  
Keyword(s):  
Opportunistic Infections ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Brazilian Amazon ◽  
Morbidity And Mortality ◽  
People Living With Hiv ◽  
Care Hospital ◽  
Aids Patients ◽  
Laboratory Parameters ◽  
Hiv Aids

Abstract Background: While antiretroviral therapy (ART) has significantly improved survival rates of people living with HIV, some regions in Brazil still show a linear trend of growth in the opportunistic infections that cause HIV-associated mortality. We aimed to describe HIV-associated morbidity and mortality among hospitalized medical patients in a tertiary care hospital in Manaus, in the Brazilian Amazon, by investigating clinical data and immunologic biomarkers in order to assess predictive factors of mortality in this patient group. Methods: We prospectively measured concentrations of cytokines Th1/Th2/Th17 and soluble CD14 (sCD14) and reviewed the laboratory parameters and opportunistic infections in outcomes of either death or discharge of eighty-three HIV/AIDS patients who were admitted in 2017-2018 to the Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD) in Manaus. Results: The mortality in the sample studied was 20.5%. Tuberculosis (TB) showed a relative risk (RR) =1.86 (confidence interval (CI) 1.14 to 2.81: and p = 0.026), and weight loss was the symptom (RR=1.81; CI: 1.21 to 2.53 and p = 0.007) most highly associated with the death outcome in HIV/AIDS inpatients. Univariable analyses showed that the eosinophil count, platelet distribution width (PDW), and alanine aminotransferase were the only laboratory parameters that differed among patients who died. In relation to cytokines and sCD14 levels, no differences were found between those who died or were discharged. A multivariable logistic regression model was used to predict mortality and showed that individuals with no digestive syndrome (especially the absence of oropharyngeal candidiasis), nor TB are 63% to 76% less likely to die, respectively. In addition, increases in PDW values also decreased the probability of death. Curiously, patients who were discharged showed a trend towards a concomitant increase in PDW and mean platelet volume (MPV) in relation to those who died.Conclusions: Opportunistic infections continue to be major events in morbidity and mortality of HIV/AIDS patients, and the relationship between increased PDW and the likelihood of survival suggests the need for future studies on innate immune response of platelets in HIV/AIDS inpatients.

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