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

Abstract

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 60 Candida 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 krusei 3%. 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.