Punjab & Haryana HC notice to govt on rampant fungal infections in ICUs

Saurabh Malik

Tribune News Service

Chandigarh, January 31

In an apparent attempt to cure ailing health facilities in hospitals across the region, the Punjab and Haryana High Court has taken suo motu cognisance of a study on fungal infections rampant in intensive care units (ICUs).

Treating the matter as public interest litigation, the Bench of Justice Satish Kumar Mittal has issued a notice to the Union of India. It has also appointed senior advocate Deepinder Singh Patwalia amicus curiae or a friend of the court to assist the Bench.

The development is significant as the nation-wide study found ICU patients of hospitals in the North most vulnerable to fungal infections. It was, in fact, as high as 8.95 cases per 1,000 ICU admissions, compared to 3.61 cases per 1,000 ICU admissions reported from the West.

The study, “Incidence, characteristics and outcome of ICU-acquired candidemia in India”, was recently published in Intensive Care Medicine journal, after a research was conducted in 27 ICUs across India.As many as 11 ICUs were from the North, three each from the East and the West, four from the central and six from the South were included in the study. The head of the Medical Microbiology Department, PGI, Dr Arunaloke Chakrabarti, was the main author of the study.

The research made it clear that life-threatening fungal infections were rampant in the ICUs of public and private hospitals in the country, particularly in the North. The purpose of the research was to carry out a systematic epidemiological study on intensive care unit-acquired candidemia across India.

Candida is yeast responsible for fungal infections in humans. The incidence of systemic Candida infections or candidemia has increased significantly in recent years. Consecutive patients, who acquired candidemia after ICU admission, were enrolled for the study from April 2011 to September 2012.

A total of 2,15,112 patients were admitted to the 27 ICUs under study during the period. Of the total, 1,400 contracted ICU-acquired candidemia, amounting to 6.51 cases per 1,000 ICU admissions. The study not only confirmed the already known risk factors for candidemia, but also revealed that the acquisition occurred early. The study found that the patients admitted to the ICUs were acquiring fungal infection within about eight days.

The study concluded that there was a high burden of candidemia in Indian ICUs, and its onset after ICU admission was early and there was “higher risk despite less severe physiology score at admission”.