Background: Candida species, mainly Candida albicans are traditionally associated with severe and debilitating diseases especially in immunocompromised hosts. Biofilm is emerging virulence factor in fungi and has been correlated with pathogenicity among Candida species. The emergence of C. albicans and non-albicans Candida (NAC) species producing biofilms and severe or recurrent infections in hospitalized patients with its attendant treatment failure and poor prognosis has become a great concern globally. Objective: To determine the species distribution of Candida organisms (C. albicans and NAC) from clinical samples and their pathogenic ability to produce biofilms; and to highlight the clinical implications of these extracellular substances to aid preventive measures, chemotherapy, and prognosis. Materials and Methods: This was a descriptive, cross-sectional study, and was carried out at SRM MCH & SR, Tamil Nadu, India. Between February 2014 and January 2015, a total of 90 Candida fungal isolates recovered from clinical samples including urine, pus, vaginal swab, skin scrapping, sputum, and blood were analyzed. Samples were cultured on Sabouraud Dextrose Agar with gentamycin. Candida organisms were identified by standard methods. Germ tube rapid test was used to differentiate C. albicans and Candida dublinieses from other Candida species. Further speciation of the isolates was carried out by culture on CHROM agar and Corn meal-Tween 80 agar, including sugar fermentation and assimilation tests. Biofilm production was detected using Congo red method. Results were analyzed statistically. Result: A total of 90 Candida organisms were recovered from clinical specimens of which 33 (36.7%) were C. albicans and 57(63.3%) were NAC species. Majority of the isolates were recovered from urine (42, 46.7%), vaginal swab (20, 22.2%), and pus (11, 12.2%) samples. Among NAC species, the most common isolate was C. tropicalis (23, 25.6%) followed by C. parapsilosis (15, 16.7%). Of the 90 Candida species analyzed, 26 (28.9%) gave positive results for biofilm production. Overall, biofilm formation was detected more frequently among NAC species (16, 61.5%) than in C. albicans (10, 38.5%). Among NAC species, C. tropicalis (12, 46.2%) produced biofilm most frequently than other members of the group. Although, most of the Candida isolates strongly producing biofilms were members of NAC species particularly C. tropicalis (3, 50%), nonetheless, majority of the weakly biofilm producers were also detected among the strains of C. tropicalis (9, 45%). Conclusion: The outcome of this study shows a notable shift in the pathogenic incidence of Candida species from C. albicans to NAC species with significant rate of pathogenic biofilm production. Biofilm production was most common in C. tropicalis than other members of NAC species whereas slime formation was not detected in C. glabrata species. There is need to create awareness among the populace and stakeholders on healthcare system management about this emerging scenario in Candida species patho...

Vulvovaginal candidiasis (VVC) is caused by Candida species. It has been associated with impact on economic cost. Currently, Non-albicans Candida species are more resistant to azoles and get converted from harmless to pathogenic state due to several virulence factors. Monitoring of the antifungal susceptibility pattern is important to know the resistant pattern of Candida species. Thus the objective of this research was to the identification of Candida in species level and to evaluate the antifungal resistance pattern in Candida species isolated from the vaginal discharge of antenatal women with vulvovaginal candidiasis. This prospective study was done in SRM MCH & RC, Chennai, India, from March 2017 and December 2018. An aggregate of 342 vaginal swabs were gathered from antenatal women of symptomatic and asymptomatic VVC. Antifungal susceptibility test was done by the disk diffusion method as per the CLSI guidelines. A total of 112 Candida species were isolated from 342 high vaginal swabs. Out of 112 Candida isolates, 65 (58%) were Non-albicans Candida (NAC) and 47 (42%) were C. albicans. In this study, 103/112(91.6%) of Candida isolates had the highest sensitivity to voriconazole and 26/112(23.2%) of Candida isolates had the highest resistance to miconazole. NAC species are emerging as potential threats to cause infection and posing a therapeutic challenge. Early empirical antifungal therapy and further research to improve diagnostic, prevention and therapeutic strategies are necessary to reduce the considerable morbidity and mortality.

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Vulvovaginal candidiasis (VVC) is a commonly found disease in antenatal women caused by Candida species. The usual presentations are persistent curdy white vaginal discharge with itching, bad odour, irritation, pain in the lower abdomen and local induration of vulva. Therefore this infection is an unpleasant and cause of intolerance for women. Several virulence factors are present in Candida species such as Secreted aspartyl proteinase (Sap), phospholipase, lipase, haemolysin, germ tube formation and production of biofilm. There are 10 SAP genes (SAP1 to SAP10) present in all Candida species which help for virulence. The objective of this research was to analyse the genotypic patterns of SAP genes in Candida species. The present research was done in SRM MCH & RC, Chennai, India, from March 2017 to December 2018. DNA was isolated and the SAP gene was detected by a polymerase chain reaction. Totally 35 Candida species were isolated from 92 suspected case of VVC. Out of 35 Candida species, 16/35 (45.7%) were from symptomatic women and 19/35 (54.3%) were from asymptomatic women. Out of 35 Candida species, C. albicans were 15(42.8%) and Non-albicans Candida (NAC) were 20(57.2%).Totally 28 genotypic patterns were found and 6 (21.4%) Candida isolates presented genotypic patterns of all the SAP genes. There is a predominance of the SAP1 gene in Candida isolates from asymptomatic women whereas SAP1 and SAP9 genes in Candida isolates from symptomatic women. The statistical analysis showed a significant difference for the SAP7 and SAP8 gene frequency among the Candida isolated from symptomatic and asymptomatic women.

Sediment cells from cell blocks can be more useful than the routine cytological methods for body fluids. The present study was conducted to compare cell block and cytological methods of body fluids. Two-year study was done in a tertiary care hospital of Punjab. Samples were taken from 90 patients, comprising 30 Ascitic, 30 Broncho alveolar lavage (BAL), and 30 pleural fluids. Cytology smears were prepared & stained with H & E stain and cellblock preparations of centrifuged deposits were processed, then sections were cut with 5 micrometers and stained with H & E stain. Sensitivity of cell blocks was found to be nearly double that of routine cytology. Cell blocks are proved to be superior to the cytological smears, when there is need for Immunohistochemistry. Use of cell blocks plays a vital role than routine cytology smears of body fluids can increase the sensitivity.