Characterization and Antifungal Susceptibility Pattern of Candida SPP . Isolated From Clinical Specimens

Abstract

BACKGROUND:With the changing health scenario fungal infections have increased significantly, contributing to morbidity, mortality and health care cost. Candida is major human fungal pathogens that cause both superficial and deep tissue infections. With emergence of nonalbicans Candida species, availability of advanced identification methods and antifungal resistance, the spectrum of candidiasis has changed. OBJECTIVE: The aim of our study was to identify the distribution of Candida species among clinical isolates, risk factors associated with candidiasis and their sensitivity pattern for common antifungal drugs. MATERIALS AND METHODS: One hundred thirty nine different clinical isolates of Candida were collected from indoor patients of a tertiary care centre of Gujarat from May 2009 to June 2010. Identification of Candida species and antifungal susceptibility testing was performed with miniAPI (Analytical Prophylactic Index) (Biomerieux, France) which is an automatic identification and susceptibility testing instrument. RESULTS: We found that the non-albicans Candida were more prevalent than Candida albicans. Candida tropicalis (48.9%) was the most common Candida spp. and also more resistant than that of C.albicans. C.albicans showed resistance against fluconazole (3.5%) and itraconazole (8.8%) whereas C.tropicalis were resistant to amphotericin B (10.3%), fluconazole (20.7%), itraconazole (32.3%), and voriconazole (23.5%) and flucytosine (5.8%). Overall resistance rates of Candida for amphotericin B, fluconazole, itraconazole, and voriconazole and flucytosine were 6.4%, 15.2%, 22.3%, 12.9%, 5% respectively. CONCLUSION: To achieve better clinical results species-level identification of Candida spp. and their antifungal sensitivity testing should be performed.

Antifungal Susceptibility Pattern of Clinical Isolates of Candida from a Tertiary Care Hospital in Chhattisgarh, India

“…[6,12] In present study, C. albicans isolates had a 97.9% susceptibility to Amphotericin B, a polyene antifungal which was comparable to finding by Capoor et al [24]. In constrat to it, sagarika et al [25] and Mokadas et al [18] reported 100% susceptibility of C. albicans to Amphotericin B.…”

“Emergence of Non albicans Candida as potential pathogen --- Change in spectrum poses therapeutic challenge”

“…Over all resistance of Candida to Amphotericin B in the present study was 5.4%, which was comparable to other studies like study by Dharwad et al 13 and Sagarika Pradhan et al 12 where 8% and 6.4% resistance was reported respectively.…”

“…The study by Dharwad et al 13 and Biradar et al 14 also had similar finding. The higher degree of resistance to fluconazole might be due to widespread and indiscriminate use of this drug for extended periods.…”

“…Maximum resistance to fluconazole was shown by Candida krusei (75%),followed by Candida glabrata (66.7%) and Candida tropicalis(26.7%) whereas study by Dharwad et al 13 reported fluconazole resistance in C. krusei, C. glabrata and C. tropicalis was 60%, 33.3% and 25% respectively.…”

“…Out of 29 blood culture that showed presence of Candida,24 were from NICU and SNCU. Thus the neonates were at higher risk of developing candidemia 5 . Study of Tavleen Jaggi 6 et al also had similar finding, where Candida was mainly isolated from blood (33.6%) and respiratory samples (20%).…”