Candidaemia in disseminated TB

Context: Disseminated TB patients are invariably immunocompromised and are susceptible to opportunistic infections. Candidaemia is an under-recognised infection in India. Therefore, we planned to evaluate the prevalence, survival and risk factors for the development of this infection in disseminated TB patients in a tertiary care hospital in southern India. Aims: To assess the prevalence of invasive candidiasis/candidaemia in disseminated TB patients in India and to determine the survival of these patients and risk factors for the development of candidaemia in disseminated TB patients Settings and Design: A prospective study conducted after obtaining the institutional ethical committee's approval. Methods and Material: Disseminated TB patients who came between February 2005 and February 2006 were included in the study after obtaining informed consent from the patients with assured confidentiality. The sources of the fungal culture were blood and ascitic fluid. Statistical analysis: Fisher's test, the level of significance was set at < 0.05 Results: 103 disseminated TB patients were enrolled into this study, but the prevalence of candidaemia was just 5%. Intravenous broad spectrum antibiotics (P<0.001), oral broad spectrum antibiotics (P<0.01) and indwelling catheters (P<0.01) were the three important risk factors. Non candida albicans species were predominantly present. Conclusions: Candidaemia has a low prevalence in Indian climatic conditions. If the risk factors associated with this infection are avoided, survival can be improved.