Background and Purpose: Routine identification of Candida species and knowledge of antibiotic susceptibility patterns can prevent diagnostic delays and help clinicians choose appropriate empirical therapies. This study aimed to identify and speciate Candida isolates from bloodstream infections and evaluate their epidemiological profile and antibiotic susceptibility pattern in a tertiary care hospital in North India. Materials and Methods: Blood samples were cultured in the Department of Microbiology of a tertiary care hospital from January 2019 to May 2021, and the samples which showed growth of Candida species (spp.) were included in this study. Candida isolates were initially characterized by conventional techniques. Further identification and antifungal susceptibility testing were performed using Vitek 2 compact automated system. Data analysis was performed using the SPSS software (Version 25.0). Results: Candida spp. were isolated from a total of 116 blood samples, 60.92% of which belonged to males. The majority (43.10%) of isolates were obtained from 0-1-month-old neonates, followed by infants (16.38%) and children in the age range of 1-17 years (16.38%). Only 6.89% of isolates were obtained from adults older than 18 years. Candida tropicalis (26.72%) was the most common species, followed by Candida pelliculosa (19.83%), Candida albicans (17.24%), Candida parapsilosis (14.66%), Candida famata (9.48%), and Candida krusei (9.48%). Other isolated species included Candida lusitaniae, Candida sphaerica, and Candida inconspicua. Out of 116 isolates, 101 isolates were subjected to Vitek 2 susceptibility testing. Overall, 21.78% (22/101) of Candida isolates were found to be resistant/intermediate. Among C. albicans isolates, resistance was observed only against voriconazole (20%) and fluconazole (5%); however, among non- albicans Candida species (NAC), resistance was observed against flucytosine (16.04%), followed by fluconazole (14.81%), voriconazole (3.70%), and caspofungin (3.70%). Conclusion: Non-albicans Candida spp. predominated over Candida albicans in causing bloodstream infections and were found to be more resistant to antifungals. Continuous surveillance is necessary to monitor changes in epidemiological and resistance patterns.

Zygomycetes have been known to cause life-threatening infections in humans which are often difficult to treat. We present a rare case of cutaneous mucormycosis in a premature neonate admitted with neonatal sepsis and necrotizing fasciitis. He was diagnosed with Lichtheimia ramosa infection and managed surgically along with Amphotericin B. Low birth weight, prematurity, respiratory distress, administration of corticosteroid and broad spectrum antibiotics were identified as the potential risk factors in this case which had led to the fungal infection. Early diagnosis and prompt management is critical in prevention of morbidity and mortality associated with the disease.

Poster session 1, September 21, 2022, 12:30 PM - 1:30 PM Objectives The aim of this study was to characterize the Candida spp. isolated from blood cultures and determine the antifungal susceptibility pattern of the Candida species prevalent in a tertiary care hospital in North India. Methods This retrospective study was conducted in Department of Microbiology of a tertiary care hospital in North India from April 2020 to March 2022. All blood cultures received in the department during this period were included in the study. Candida species isolated were identified and antifungal susceptibility testing was performed by VITEK as per standard protocol, The susceptibility pattern of 50 isolates was also performed by the broth microdilution method as per Clinical and Laboratory Standards Institute guidelines (CLSI) and the results were compared with VITEK results. Results Out of 21 804 blood cultures received during this period, 177 grew Candida species. Therefore, the overall prevalence of Candida species was 0.81% in our study. The incidence of bloodstream infection caused by non-albicans Candida species (80%) was higher than C. albicans (20%). Among NAC species, C. tropicalis (45%) was the most common, followed by C. pelliculosa (15%). Candidemia was predominantly observed in ICU patients. Resistance was seen in 14.1% isolates to voriconazole and fluconazole, 4.2% to flucytosine and 3.9% to caspofungin and amphotericin-B. No resistance was seen to micafungin. A total of 15% of the isolates were resistant to more than one drug. Conclusion There was a predominance of non-albicans Candida over C. albicans. Maximum resistance was seen to voriconazole followed by fluconazole. Continuous surveillance is necessary to follow trends and monitor changes in epidemiological and resistance patterns in different geographical regions, especially in critically ill patients.

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