Isolation, speciation and antifungal susceptibility testing of Candida isolates from various clinical specimens at a tertiary care hospital, Nepal

Khadka, Sundar; Sherchand, Jeevan Bahadur; Pokhrel, Bharat Mani; Parajuli, Keshab; Mishra, Shyam Kumar; Sharma, Surabhi; Shah, Niranjan Prasad; Kattel, Hari Prasad; Dhital, Subhash; Khatiwada, Sulochana; Parajuli, Narayan Prasad; Pradhan, Manoj; Rijal, Basista Prasad

doi:10.1186/s13104-017-2547-3

Cited by 42 publications

(46 citation statements)

References 21 publications

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“…The commonest sample received were sputum (45%) and urine (33.5%) followed by other less common samples like pus (12%), vaginal swabs (5%), endotracheal secretion (1.5%), blood (1.5%) and tissue (1.5%). This was in accordance with other studies [2,6,[8][9][10]. The commonest isolate was C. albicans (58%) followed by C. tropicalis (20%), C. glabrata (10%), C. parapsilosis (9%) and C. krusei (3%).…”

Section: Discussionsupporting

confidence: 92%

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Speciation and antifungal susceptibility testing of Candida isolates in various clinical samples in a tertiary care hospital in Mumbai

Jangla

Naidu

Patel

2018

Int Jour of Biomed Res

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Background: Over the last few years fungal infection rates have increased and a change is seen in their epidemiology and antifungal susceptibility pattern. Hence this study was conducted to learn the distribution of Candida species in various samples and their antifungal susceptibility pattern.Material and Methods: A total of 60Candida isolates were included in the study. Identification was done by colony morphology and Gram stain. Speciation was carried out by Germ-tube test, urease test, chlamydoconidia production test, colony characteristics on chromogenic agar medium, sugar assimilation test,sugar fermentation testand Vitek2 compact(Biomeriux, France) using ID-YST cards. Antifungal testing was done on Vitek2 compact using AST YS01 cards which included fluconazole, voriconazole, amphotericin b, caspofungin, micafungin and flucytosine.Results: 60 Candida isolates were included in this study. Samples from which Candida species were isolated were sputum (45%), urine (33.5%), pus (12%), vaginal swab (5%), endotracheal secretion (1.5%), blood (1.5%) and tissue (1.5%). Isolates from males and females were 30% and 70% respectively. Isolates from geriatric age group (>65 years) and adults (18-65 years) were 52% and 48% respectively. Isolates from samples received from IPD, OPD and ICU were 58%, 34% and 8% respectively. Out of all isolates, Candida albicans was 58%, Candida tropicalis 20%, Candida glabrata 10%, Candida parapsilosis 9% and Candida krusei3%. All Candida species (except Candidaglabrata) showed 100% sensitivity to amphotericin b and caspofungin. Sensitivity to azole group of drugs was 100% among NAC except C. glabrata and C. krusei and more than 90% among C. albicans.Conclusion: Candida albicans was the commonest isolate followed by C. tropicalis among the NAC. Overall also, C. Albicans were predominant as compared to Non albicans Candida (NAC) species. All Candidaisolates except (C. glabrata) showed good sensitivity to all antifungals.

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Section: Discussionsupporting

confidence: 92%

“…Overall also, C. albicans (58%) pre-dominated as compared to NAC (42%). This was also observed in separate studies by Khadka et al and Khan et al [10,11]. This shows that NAC infections are also gaining importance as is also documented in another study by Bajwa and Kulshreshtha which showed that NAC rates in India range from 52% to 96% [12].…”

Section: Discussionsupporting

confidence: 78%

Speciation and antifungal susceptibility testing of Candida isolates in various clinical samples in a tertiary care hospital in Mumbai

Jangla

Naidu

Patel

2018

Int Jour of Biomed Res

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“…Similar findings were found in a study where Candida species were found to be more susceptible to clotrimazole (82%) followed by miconazole (44%) respectively whereas 20% of total isolates were found to be resistant to fluconazole by disc diffusion method. 21 In previous studies the Candia spp was sensitive to antifungal agents. In Jordan, Al-Abeid et al (2004) showed that all tested Candida were susceptible to nystatin, miconazole, ketoconazole and fluconazole.…”

Section: Discussionmentioning

confidence: 93%

Disk diffusion Method in Enriched Mueller Hinton agar for determining susceptibility of Candida isolates from various clinical specimens

Mahboob¹,

Iqbal²,

Ahmed³

et al. 2020

J Dhaka Med Coll

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Background: Candida species are responsible for various clinical infections ranging from mucocutaneous infection to life threatening invasive diseases. Recently there is a serious concern with increased resistance of antifungal drugs and its consequences. Thus, identification of Candida and its antifungal susceptibility testing has a paramount significance in the management of Candidal infections. The aim of the study was to determine antifungal susceptibility pattern of Candida by Mueller-Hinton agar media supplemented with glucose and methylene blue for disk diffusion testing of fluconazole, miconazole, clotrimazole, amphotericin B and nystatin. Methods: A total of 35 Candida species was isolated from 2000 clinical specimens over 6 month’s period from July 2016 to December 2016. Growths on Blood agar and chromogenic agar were evaluated for colony appearance and microscopic examination. Antifungal susceptibility testing was performed by disk diffusion using Mueller-Hinton agar supplemented with glucose and methylene blue. Results: Candida species were more sensitive to clotrimazole (88.58%) and amphotericin B (88.58%) followed by nystatin ((77.14%), miconazole (74.29%) whereas fluconazole showed the highest level of resistance (60%). Conclusions: The increase in resistance to fluconazole is of serious concern as it is the most commonly used azole for candidiasis. The sensitivity profile of Candida isolates will be helpful to choose appropriate antifungal agents, thus decreasing patient’s morbidity and mortality. J Dhaka Medical College, Vol. 28, No.1, April, 2019, Page 28-33

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“…Similar results for fluconazole and voriconazole sensitivity have also been obtained by Padawer D et al from Israel, Alkilani AA et al from Egypt and Khadke S et al from Nepal. [17][18][19] Two strains out of 113 (1.8%) isolated Candida were found as Susceptible dose dependant (S-DD). All the fluconazole resistant and S-DD isolates were further confirmed by E-test in our study, and it was found that both S-DD isolates proved to be resistant with MIC values >64.…”

Section: Resultsmentioning

confidence: 99%

Candiduria: its characterization, antifungal susceptibility pattern and biofilm formation

Prakash¹,

Verma²,

Agarwal³

2018

Int J Res Med Sci

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Background: Candida are the fourth most common species causing urinary tract infections. The last two decades has shown rapid increase in Candida associated UTI along with change in its distribution. The indiscriminate use of antifungal drugs, especially azole group have contributed in emergence of resistant strains of Candida. Biofilm producing property of Candida also contributes to antifungal resistance. Aims and objectives was to detect the occurrence of Candida as causative agent of UTI and a potent bio film producer. The susceptibility of Candida to antifungal drugs and their correlation with the production of bio film and presence of Foleys catheter was also determined.Methods: A total of 4192 urine specimens were analysed. Candida species isolated from urine samples were characterized using CHROM agar, sugar assimilation tests and micro morphology on corn meal agar. The antifungal susceptibility testing was performed by modified disc diffusion method on MHA with two drugs; fluconazole 25µg, and voriconazole 1µg discs. The biofilm production capability was tested according to the protocol proposed by Branchini et al.Results: Out of 113 Candida species isolated, 16.8% were Candida albicans as compared to 83.2% non albicans, with Candida tropicalis as the most common species. Antimicrobial sensitivity by modified Kirby Bauer disc diffusion method showed 74.3 % of Candida isolates to be fluconazole sensitive while sensitivity to voriconazole was 100%. 60.2% of Candida were biofilm producers out of which 48.5 % were from urine samples of catheterized patients. Similarly, 26.4 % of fluconazole resistant strains were also biofilm producers.Conclusions: The increased incidence of Non albicans candiduria which are also biofilm producers and resistant to commonly used drug fluconazole is a matter of concern. Therefore, the species identification of Candida isolates along with their antifungal susceptibility pattern should be routinely performed to help the clinicians in better treating the patients with candiduria.

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Isolation, speciation and antifungal susceptibility testing of Candida isolates from various clinical specimens at a tertiary care hospital, Nepal

Cited by 42 publications

References 21 publications

Speciation and antifungal susceptibility testing of Candida isolates in various clinical samples in a tertiary care hospital in Mumbai

Speciation and antifungal susceptibility testing of Candida isolates in various clinical samples in a tertiary care hospital in Mumbai

Disk diffusion Method in Enriched Mueller Hinton agar for determining susceptibility of Candida isolates from various clinical specimens

Candiduria: its characterization, antifungal susceptibility pattern and biofilm formation

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