DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20192626

Isolation, identification and antifungal susceptibility of Candida in patients with fungal sepsis

Bilal Ahmad Wani, Mohd Rafiq Lone, Najmus Saqib

Abstract


Background: In this study, our aim was to identify and isolate Candida species from patients admitted in ICU,s of our hospital and to determine their susceptibilities to various antifungal agents so as to find the local resistance pattern and guide for empirical treatment.

Methods: In our study 37 strains of candida were isolated (4 Candida albicans, 33 Non-albicans Candida strains). Candida species were identified by conventional, biochemical and molecular methods. Antifungal susceptibility tests for amphotericin B, fluconazole, itraconazole, ketoconazole and voriconazole were performed with broth microdilution method and E- tests as described by National Committee for Clinical Laboratory Standards (NCCLS).

Results: Out of 37 Candida strains, the most prevalent species were C. tropicalis (43.2%), C. parapsilosis (24.3%), C. krusei (16.2%), C. albicans (10.8%), and C. glabrata (2.7%). Among all strains four strains (10.8 %) were resistant, two Candida albicans where found resistant to fluconazole one Candida krusei and one Candida parapsilosis were found to be resistant to all azoles.

Conclusions: Candidemia continues to be associated with substantial morbidity and mortality and non albicans Candida species are the commonly isolated pathogen from those patients admitted in tertiary care hospitals in Indian scenario. Thus, it is imperative to perform antifungal susceptibility to select appropriate and effective antifungal therapy.


Keywords


Anti-fungal susceptibility, Broth microdilution method, Candida, E-test

Full Text:

PDF

References


Epstein JB, Komiyama K, Duncan D. Oral topical steroids and secondary oral candidiasis. J Oral Med. 1986;41(4):223-7.

Pomerantz S, Sarosi GA. Fungal diseases in AIDS. Current Opinion in Infectious Diseases. 1992;5(2):226-30.

Allen CM, Saffer A, Meister RK, Beck FM, Bradway S. Comparison of a lesion‐inducing isolate and a non‐lesional isolate of Candida albicans in an immunosuppressed rat model of oral candidiasis. J Oral Pathol Med. 1994;23(3):133-9.

McIlroy MA. Failure of fluconazole to suppress fungemia in a patient with fever, neutropenia, and typhlitis. J Infect Dis. 1991;163(2):420-1.

Marsh PD, Martin M. Oral fungal infections, in Oral Microbiology, Churchill Livingstone, Edinburgh, UK; 2009:166-179.

Akbar DH, Tahawi AT. Candidemia at a university hospital: epidemiology, risk factors and predictors of mortality. Ann Saudi Med. 2001;21(3/4):178-82.

Chakrabarti A, Chatterjee SS, Rao KL, Zameer MM, Shivaprakash MR, Singhi S, etal. Recent experience with fungaemia: change in species distribution and azole resistance. Scandinavian J Infect Dis. 2009;41(4):275-84.

Samaranayake LP, MacFarlane TW, Williamson MI. Comparison of Sabouraud dextrose and Pagano-Levin agar media for detection and isolation of yeasts from oral samples. J Clin Microbiol. 1987;25(1):162-4.

Davenport JC, Wilton JM. Incidence of immediate and delayed hypersensitivity to Candida albicans in denture stomatitis. J Dental Res. 1971;50(4):892-6.

Ellepola AN, Morrison CJ. Laboratory diagnosis of invasive candidiasis. J Microbiol. 2005;43(1):65-84.

Chakrabarti A, Ghosh A, Batra R, Kaushal A, Roy P, Singh H. Antifungal susceptibility pattern of non-albicans Candida species & distribution of species isolated from Candidaemia cases over a 5 year period. Indian J Med Res. 1996 Aug;104:171-6.

Rani R, Mohapatra NP, Mehta G, Randhawa VS. Changing trends of Candida species in neonatal septicaemia in a tertiary North Indian hospital. Indian J Med Microbiol. 2002;20(1):42-44.

Kao AS, Brandt ME, Pruitt WR, Con LA, Perkina BA, Stephens DS, et al. Active Surveillance Clinical Infectious Disease. The Epidemiology of Candidemia in Two United States Cities. Results of Population Based. 1999,116421170.

St-Germain G, Laverdiere M, Pelletier R, Bourgault AM, Libman M, Lemieux C et al. Prevalence and Antifungal Susceptibility of 442Candida Isolates from Blood and Other Normally Sterile Sites: Results of a 2-Year (1996 to 1998) Multicenter Surveillance Study in Quebec, Canada. J Clin Microbiol. 2001;39(3):949-53.