Candida Prevalence and Its Antifungal Susceptibility in Various Clinical Specimens in Tertiary Care Centre.
Candida Prevalence and Its Antifungal Susceptibility
Keywords:
Candida albicans, Non albicans candida, Methylene blue containing Muller Hinton agar, Antifungal drug susceptibilityAbstract
Background: The purpose of this study was to isolate the Candida spp. & examine their susceptibility to antifungal drugs from various clinical specimens. One hundred fifty isolates of Candida spp. were included in this study. Clinical history revealed that all patients were on systemic broad spectrum antibacterial drugs. Materials and Methods: Candida spp. was differentiated by germ tube test, culture characteristics on special media for fungus, sugar fermentation, sugar assimilation and growth on corn meal agar. Antifungal drug susceptibility testing against Fluconazole, Ketoconazole, Itraconazole, Voriconazole, Nystatin and Amphotericin B were done on basis of CLSI guidelines on Methylene blue containing Mueller Hinton Agar by disk diffusion method. Result: We found 52% and 48%, C.albicans & Non albicans candida spp., respectively. There were no resistance to Nystatin and Amphotericin B. C.albicans was more susceptible than Non albicans candida. Nystatin & Amphotericin B were susceptible to all isolated Candida spp. In present scenario, Fluconazole is most commonly used empirical antifungal drug, which is more effective to C.albicans than Non albicans Candida. Conclusion: Due to emergence of resistance in Azole group of antifungal among Non albicans candida, it should be mandatory to use antifungal drugs as per the susceptibility testing.
References
2. Bailey & Scott’s “Diagnostic Microbiologyâ€, 12th ed. Chapter 50; 629-717.
3. Clinical and Laboratory Standards Institute (CLSI). Methods for Antifungal Disk Diffusion Susceptibility Testing of Yeasts; Approved Guideline – 2nd ed. M44-A, Vol. 29 No. 17.
4. Alvarez-Lerma F, Nolla-Salas J, León C, Palomar M, Jordá R, Carrasco N et al. Candiduria in critically ill patients admitted to intensive care medical units. Intensive Care Med. 2003;Jul; 29: 1069-76
5. MR Capoor, D Rawat, D Nair, M Deb, P Aggarwal. Evaluation of Gluose Methylene Blue Mueller Hinton Agar for E- test minimum inhibitory concentration determination in Candida spp. Indian J Med Microbiol.2007; 25: 432-433.
6. Warren NG, Hazen KC. Candida, Cryptococcus and other yeasts of Medical Importance. Chapter 61. In: Manual of Clinical Microbiology, 6th ed.
7. Narang A, Agrawal PR, Chakrabarti A. Kumar P. Epidemiology of systemic candidiasis in a tertiary care neonatal unit. J Trop pediatrics 1998: 44(2):104-108.
8. Fisher & Cook. Fundamentals of Diagnostic Mycology ed. reprinted 1998. Chapter 7,196-230.
9. Falagas ME, Roussos N, Vardakas KZ. Relative frequency of C. albicans and Non albicans candida spp. Among candidemia isolates from inpatients in various parts of the world: A systemic review. Int J Infect Dis 2010; 14; e954-66.
