RecruitingNCT06103331

Fungal Surveillance in Bangladesh

Surveillance for Invasive Fungal Infections in Selected Hospitals in Dhaka City, Bangladesh

Sponsor

International Centre for Diarrhoeal Disease Research, Bangladesh

Enrollment

800 participants

Start Date

Jan 20, 2022

Study Type

OBSERVATIONAL

Conditions

Invasive Fungal Infections

Summary

This will be an exploratory descriptive study designed to conduct surveillance for the identification of invasive fungal pathogens among hospitalized patients in Bangladesh at two tertiary care acute-level hospitals. including the Dhaka Medical College Hospital, the Dhaka Hospital of icddr,b, and the National Institute of Cancer Research Hospital (NICRH). Respiratory samples, blood, urine, cerebrospinal fluid, surgical wound infection swabs, and other samples including biopsy tissue specimens will be obtained at intensive care units, general medicine and surgery wards, post-operative care, etc. The collected specimens will be sent to the clinical microbiology laboratories of the surveillance hospitals or to the pathology laboratory (biopsy tissue specimens) to test for Aspergillus, Histoplasms, Candida, Pneumocystis, Cryptococcus, and Mucormycetes. The lab. methods will include microscopy, staining, culture, and biochemical tests mainly and if feasible then some specimens may undergo molecular or immunological methods.

Eligibility

Min Age: 0 Months

Inclusion Criteria23

Must include all of the following criteria:
Admitted/hospitalized patients of any age and gender in tertiary-level acute care hospitals AND
Having any of the following co-morbid immunosuppressive conditions or risk factors for healthcare-associated fungal infections such as:
Chronic lung conditions including asthma, COPD
Hemodialysis patients,
diabetes,
Patients receiving chemotherapy or immunosuppressive drugs (e.g. corticosteroids, immunosuppressive drugs among organ transplant recipients), for ≥7 days
Patients with AIDS
Patients at risk of healthcare-associated infections (e.g., Patients under postoperative care, having a urinary catheter, with tracheal intubation, under ventilatory support, secured with intravenous (IV) cannula, any other invasive procedures, etc.)
Hospitalized Patients under prolonged injectable antibiotic treatment (>7 days)
Prolonged hospitalization more than 7 days.
History of taking steroids or antibiotics for more than 2 weeks prior to hospitalization
AND
Patients or caregivers providing consent
to 59-month-old children of either sex admitted in hospital with any illness.
Have features of sepsis/pneumonia (based on clinical features below)
And any of the following criteria:
Those who will fail to respond to injectable antibiotics or both 1st and 2nd line antibiotics (1st line- inj. Ampicillin plus gentamicin, 2nd line- inj. Ceftriaxone plus levofloxacin/gentamicin as per icddr,b hospital protocol)
Any child with SAM or h/o recent measles or any condition that may induce immune suppression plus fail to respond to injectable antibiotics/ 1st line antibiotics (1st line antibiotics- inj. Ampicillin +inj. Gentamicin)
Those who will develop late-onset hospital-associated infection (LOHAI)
Any child who will require ICU care for more than 7 days
Develop extensive thrush after taking long-term injectable antibiotics
History of taking steroids or antibiotics for more than 2 weeks prior to hospitalization