Species Distribution, Antifungal Susceptibility, and Molecular Epidemiology of Candida Species Causing Candidemia in a Tertiary Care Hospital in Bangkok, Thailand

Candida species represent a common cause of bloodstream infection (BSI). Given the emergence of non-albicans Candida (NAC) associated with treatment failure, investigations into the species distribution, fungal susceptibility profile, and molecular epidemiology of pathogens are necessary to optimize the treatment of candidemia and explore the transmission of drug resistance for control management. This study evaluated the prevalence, antifungal susceptibility, and molecular characteristics of Candida species causing BSI in a tertiary-level hospital in Bangkok, Thailand. In total, 54 Candida isolates were recovered from 49 patients with candidemia. C. tropicalis was the most prevalent species (33.3%), followed by C. albicans (29.6%). Most Candida species were susceptible to various antifungal agents, excluding C. glabrata and C. tropicalis, which had increased rates of non-susceptibility to azoles. Most C. glabrata isolates were non-susceptible to echinocandins, especially caspofungin. The population structure of C. albicans was highly diverse, with clade 17 predominance. GoeBURST analysis of C. tropicalis revealed associations between genotype and fluconazole resistance in a particular clonal complex. The population structure of C. glabrata appeared to have a low level of genetic diversity in MLST loci. Collectively, these data might provide a fundamental database contributing to the development of novel antifungal agents and diagnostic tests.

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Antifungal Susceptibility Pattern of Candida Isolates: A Comparison in H.I.V. Positive and Negative Patients from A Tertiary Care Hospital of Northern India

Journal of Pure and Applied Microbiology ◽

10.22207/jpam.15.3.12 ◽

2021 ◽

Author(s):

Parvez Anwar Khan ◽

Nazish Fatima ◽

Haris Manzoor Khan ◽

Midhat Ali Khan ◽

Asim Azhar ◽

...

Keyword(s):

Candida Species ◽

Antifungal Agents ◽

Antifungal Susceptibility ◽

Tertiary Care ◽

Empirical Therapy ◽

Resistance Pattern ◽

Care Hospital ◽

Sensitivity Testing ◽

Fluconazole Resistance ◽

Broth Microdilution Method

Candidiasis is recognized as a significant cause of morbidity, especially in immunocompromised individuals. An epidemiologic change in Candida species and emergence of resistance can impact the usage of antifungal agents as empirical therapy for Candidiasis in patients with or without AIDS. The present study was done to find out: i) The species of Candida isolated from H.I.V. and Non-HIV infected patients. ii) The resistance pattern of these Candida isolates to antifungal agents. A total of 160 Candida species isolates (80 isolates each from H.I.V. and Non-HIV infected patients) were characterized. Identification of yeast isolates was made by standard procedures including morphology (Staib agar, cornmeal agar, CHROMagar), germ tube test, fermentation, and assimilation of sugars and growth at 42°C. In addition, sensitivity testing was done using the broth microdilution method (M27-A2) as per the C.L.S.I. guidelines against amphotericin B, nystatin, voriconazole, fluconazole, ketoconazole, and itraconazole. In both the groups, i.e., H.I.V. and Non-HIV infected patients, Candida albicans was the most common species (61.2 % and 85 % respectively), followed by Candida guilliermondi (16.2 % and 5 %), Candida tropicalis (5 % and 3.7 %), Candida krusei (5% and 2.5 %), Candida dubliniensis 1(5 % and 1.2 %) and others. Among HIV infected patients fluconazole resistance was 16.25%, ketoconazole 13.5%, clotrimazole 12.5%, itraconazole 6.25 %. In the non-HIV infected group, fluconazole resistance was 8.75% and itraconazole 1.25%. For the appropriate treatment of Candida infections, antifungal susceptibility has become an essential tool, especially in the present scenario of increasing resistance.

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Molecular identification, species distribution and antifungal susceptibility profile of Candida species isolated from ICU patients in a tertiary care hospital

10.26226/morressier.5ac39995d462b8028d899d3b ◽

2018 ◽

Author(s):

RUNGMEI S Marak

Keyword(s):

Molecular Identification ◽

Species Distribution ◽

Candida Species ◽

Tertiary Care Hospital ◽

Antifungal Susceptibility ◽

Tertiary Care ◽

Care Hospital ◽

Icu Patients

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Candidemia in a Brazilian tertiary care hospital: species distribution and antifungal susceptibility patterns

Revista do Instituto de Medicina Tropical de São Paulo ◽

10.1590/s0036-46652004000500001 ◽

2004 ◽

Vol 46 (5) ◽

pp. 239-241 ◽

Cited By ~ 34

Author(s):

Ana Graciela Ventura Antunes ◽

Alessandro Comarú Pasqualotto ◽

María Cristina Diaz ◽

Pedro Alves d'Azevedo ◽

Luiz Carlos Severo

Keyword(s):

Species Distribution ◽

Candida Species ◽

Antifungal Susceptibility ◽

Tertiary Care ◽

Epidemiological Surveillance ◽

Care Hospital ◽

Microdilution Method ◽

Broth Microdilution Method ◽

Invasive Infections ◽

Dose Dependent

Recent studies have shown differences in the epidemiology of invasive infections caused by Candida species worldwide. In the period comprising August 2002 to August 2003, we performed a study in Santa Casa Complexo Hospitalar, Brazil, to determine Candida species distribution associated with candidemia and their antifungal susceptibility profiles to amphotericin B, fluconazole and itraconazole. Antifungal susceptibility was tested according to the broth microdilution method described in the NCCLS (M27A-2 method). Only one sample from each patient was analyzed (the first isolate). Most of the episodes had been caused by species other than C. albicans (51.6%), including C. parapsilosis (25.8%), C. tropicalis (13.3%), C. glabrata (3.3%), C. krusei (1.7%), and others (7.5%). Dose-dependent susceptibility to itraconazole was observed in 14.2% of strains, and dose-dependent susceptibility to fluconazole was found in 1.6%. Antifungal resistance was not found, probably related to low use of fluconazole. Further epidemiological surveillance is needed.

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PHENOTYPIC CHARACTERIZATION OF CLINICAL ISOLATES OF CANDIDA SPECIES AND ITS SUSCEPTIBILITY TO VARIOUS ANTIFUNGAL AGENTS: A STUDY FROM A TERTIARY CARE HOSPITAL IN WESTERN UTTAR PRADESH

10.36106/ijar/7104512 ◽

2021 ◽

pp. 57-59

Author(s):

Navdeep Gambhir ◽

Abhigyan Goel ◽

Anita Pandey ◽

Arjun Singh Bisht ◽

Sadab Khan ◽

...

Keyword(s):

Candida Species ◽

Antifungal Agents ◽

Susceptibility Testing ◽

Antifungal Susceptibility ◽

Tertiary Care ◽

Antifungal Susceptibility Testing ◽

Phenotypic Characterization ◽

Clinical Samples ◽

Care Hospital

Background: Indiscriminate use of antifungal agents has led to rise in infections caused by Candida species in recent years. Studies on characterization of Candida species followed by antifungal susceptibility testing can be benecial in managing this problem. Objectives: To phenotypically characterize Candida species isolated from various clinical samples and to determine its susceptibility to various antifungal agents. Methods: A total of 119 Candida spp. isolated from various clinical samples were subjected for species identication and antifungal susceptibility testing using an automated Vitek-2 compact system. Results: There was predominance of Non albicans (NAC) species (82.35%) isolated from our Hospital. Candida species were isolated predominantly from blood (68.06%) sample followed by urine (26.05%). C. tropicalis was the predominant NAC species isolated (27.73%) followed by C.krusei, C.guilliermondii (12.61% each), C.parapsilosis (10.08%) and C. glabrata (7.56%). Overall the NAC isolates were resistant to uconazole, voriconazole, caspofungin, micafungin, amphotericin-B, and ucytosine as compared to C. albicans. Conclusion: Predominance of NAC species and emergence of antifungal drug resistance among NAC species is a matter of concern. Thus highlighting that susceptibility should be performed in all cases to achieve good therapeutic results. Strict infection control strategies and a restrictive antifungal policy should be implemented for better clinical outcome.

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Prevalence of non-albicans Candida species and antifungal susceptibility in intensive care unit patients of a tertiary care hospital in Assam

Indian Journal of Medical Microbiology ◽

10.1016/j.ijmmb.2021.08.381 ◽

2021 ◽

Vol 39 ◽

pp. S111

Author(s):

Prativa Sahu ◽

Reema Nath

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Candida Species ◽

Tertiary Care Hospital ◽

Antifungal Susceptibility ◽

Tertiary Care ◽

Care Hospital

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Epidemiology, Species Distribution, Antifungal Susceptibility and Outcome of Nosocomial Candidemia in a Tertiary Care Hospital in Italy

PLoS ONE ◽

10.1371/journal.pone.0024198 ◽

2011 ◽

Vol 6 (9) ◽

pp. e24198 ◽

Cited By ~ 131

Author(s):

Matteo Bassetti ◽

Lucia Taramasso ◽

Elena Nicco ◽

Maria Pia Molinari ◽

Michele Mussap ◽

...

Keyword(s):

Species Distribution ◽

Tertiary Care Hospital ◽

Antifungal Susceptibility ◽

Tertiary Care ◽

Care Hospital ◽

Nosocomial Candidemia

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Epidemiology of bloodstream Candida species in a Spanish tertiary care hospital as a guide for implementation of T2MR (T2CANDIDA®) for rapid diagnosis of candidemia

Medical Mycology ◽

10.1093/mmy/myaa056 ◽

2020 ◽

Author(s):

Iker Falces-Romero ◽

María Pilar Romero-Gómez ◽

Francisco Moreno-Ramos ◽

Jesús Mingorance ◽

Julio García-Rodríguez ◽

...

Keyword(s):

Candida Species ◽

Antifungal Susceptibility ◽

Tertiary Care ◽

Common Species ◽

Care Hospital ◽

Clinical Value ◽

Negative Results ◽

Resistance Patterns ◽

Resistance Rates ◽

Susceptibility Patterns

Abstract The aim of this work was to study the epidemiology of candidemia in our hospital in order to determine whether the T2MR system might be a useful tool for early diagnosis of candidemia in selected units. We perform a retrospective review of all candidemia episodes registered in the last 12 years in selected units of our hospital in adult and pediatric patients. Candida species and antifungal susceptibility patterns were registered. A total of 686 isolates were registered, of which 625 were infections due to the five most common species of Candida. C. albicans (45.6%) and C. parapsilosis (33.1%) were the predominant species found in our institution. In adults these species were closely followed by C. glabrata (12–21%) in all units. While in pediatric medical and intensive care units (PICU), these species were followed by other uncommon yeasts. Resistance rates to triazoles were low in C. albicans and C. parapsilosis. In C. glabrata and C. tropicalis the resistance rates to fluconazole ranged from 10.86 to 6.67%. Resistance rates for echinocandins were very low and all strains were susceptible to amphotericin B. T2Candida® might be useful to guide antifungal targeted treatment and discontinuation of antifungal empirical treatment in those units where the five most common Candida species represent more than the ninety percent of the isolates. The selection of medical and surgical units should be based on local epidemiology and antifungal susceptibility patterns. Incidence should be taken into account in order to make clinical decisions based on negative results. Lay Abstract T2Candida® might be useful selectively in clinical units according to their local epidemiology, antifungal resistance patterns, and incidence of candidemia. It optimizes the clinical value of positive results supporting decisions about targeted therapies or discontinuations based on negative results.

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