No abstract

Systemic candidiasis (SC) is the most common invasive fungal infection as the nosocomial infection in patients undergoing major surgeries during prolonged neutropenia, transplantation and extended hospital stay of days to weeks. [1] This infection is potentially a life-threatening complication in immunocompromised patients. The introduction of novel antineoplastic agents, antifungals, antibacterial, and antivirals over the past 10 years has led to a shift in fungal epidemiology [2,3] and fever without specific signs and symptoms of localized fungal infection is the most common clinical presentation. Intensive and long-term use of antifungals leads to a decline in sensitivity and resistance development of Candida strains. [4] Antifungal resistance surveillance serves as a major strategy for prophylaxis, empirical therapy, and treatment of SC. For the management of patients suffering from SC, determination of the changes in the distribution of Candida species and respective sensitivity pattern to antifungal agents are important.Antifungal prophylaxis is warranted in patients with developing risk of SC. As definitive early diagnosis is difficult, empiric therapy of antifungal agents has become a standard of practice in immune-suppressed patients like neutropenic patients who had received broad-spectrum antibacterial therapy but remain persistently febrile. The antifungal susceptibility testing of pathogenic fungi can manage the selection of adequate therapy and also provide an estimate of antifungal efficacy. Monitoring

Background: Tracheostomy is an important surgical procedure in the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease (COVID-19) pandemic, particularly those patients undergoing prolonged tracheal intubation. The timing and indications for tracheostomy in COVID-19 patients with ventilators are still controversial. Methods: We prospectively studied the best timing for performing surgical tracheostomy in COVID-19 patients (n = 22) from April 2020 to May 2021 in the COVID-19 ICU attached to our COVID-19 hospital. The tracheotomised patients were followed up and the number and timing of the death were documented. Results: There were 14 males (male:female = 1.75:1). The mean duration of endotracheal intubation to tracheostomy was 14.4 days (range 10-22 days). The mean time for tracheostomy was 18.45 min (range 12–25 min). Five patients (22.7%) died after tracheostomy. The median time between tracheostomy and death was 4 days. Conclusions: Surgical tracheostomy has to be performed in a proper time with safe manner for benefit of the patients with COVID-19 and the health care professionals managing the patient.