BACKGROUND: Candida species can be either commensals or opportunistic pathogens with the ability to cause a variety of infections, ranging from superficial to life threatening. Nosocomial infections due to candida are also becoming increasingly important. Early and prompt diagnosis, proper treatment and prevention of candidemia due to biofilms pose a major challenge for microbiologists and clinicians worldwide. Added to this is the emerging trend of antifungal drug resistance among the biofilm producing strains of Candida. AIMS: The aim of this study was to detect biofilm production in Candida species isolated from various clinical samples obtained from patients hospitalized in Dr. B.R Ambedkar Medical College and Hospital. MATERIALS AND METHODS: A total of 108 Candida species (Candida albicans49 and non-albicans Candida59 species) isolated from various specimens (urine, blood, respiratory tract, genital samples, plastic devices and pus samples) were included in the study.The various candida isolates were identified by using conventional methods and their ability to produce biofilm was detected by the tube method. RESULTS: Out of 108 candida species, non-albicans Candida 59(54.63%) was the predominant species isolated. Biofilm positivity was seen with 71(65.74%) isolates and the biofilm production was observed more with non-albicans Candida species 44(61.97%) compared to C.albicans species 27(38.03%). Among the non-albicans Candida species, strong biofilm producers were C.krusei(80.77%) and C.tropicalis(72.73%). Biofilm positivity was found to be higher in the bloodstream Candida isolates (81.82%) compared to isolates from other sites. CONCLUSION: The present study suggests an increasing prevalence of non-albicans Candida species in the various clinical samples isolated and also shows them as strong biofilm producers compared to C.albicans species. These data suggest that, biofilm formation as a potential virulence factor might have a higher significance for non-albicans Candida species than for C.albicans and also that the biofilm structure varies with the different species and strains of candida, the nature of the colonized surface and its localization. Thus more remains to be determined about biofilms formed by the non-albicans Candida species as they are now frequently encountered species in catheter associated candidaemias.

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Introduction: Ventilator-associated pneumonia (VAP), an important form of hospital-acquired pneumonia (HAP), specifically refers to pneumonia developing in a patient on mechanical ventilator for more than 48 h after intubation or tracheostomy. Despite the advancements in antimicrobial regimes, VAP continues to be an important cause of morbidity and mortality. VAP requires a rapid diagnosis and initiation of appropriate antibiotic treatment, as there is adverse effect of inadequate antibiotic treatment on patients' prognosis and the emergence of multidrug-resistant (MDR) pathogens.Aims: The present study was undertaken to assess the etiological agents of early-onset and late-onset VAP and to know their sensitivity pattern. Material and Methods:VAP data over a period of 12 months (February 2012 -February 2013 in a tertiary care ICU was retrospectively analysed. The patients were stratified by age, sex, duration of VAP (Early/Late onset) and the identified pathogens with their sensitivity pattern.Results: Incidence of VAP was found to be 35.14%, out of which 44.23% had early-onset (<4 days MV) VAP and 55.77% had lateonset (>4 days MV) VAP. The most common organisms isolated in early onset and late onset VAP was Pseudomonas aeruginosa, E.coli and Acinetobacter baumanii. All enterobacteriaceal isolates were extended spectrum beta lactamase (ESBL) producing organisms and all Staphylococcus aureus isolates except one were methicillin resistant. The incidence of Multidrug resistant (MDR) Pseudomonas aeruginosa and Acinetobacter were 40% and 37.5% respectively.Conclusion: Due to the increasing incidence of multidrugresistant organisms in our ICU, early and correct diagnosis of VAP is an urgent challenge for an optimal antibiotic treatment and cure. Hence, knowing the local microbial flora causing VAP and effective infection control practices are essential to improve clinical outcomes.

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