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

2021 ◽  
pp. 57-59
Author(s):  
Navdeep Gambhir ◽  
Abhigyan Goel ◽  
Anita Pandey ◽  
Arjun Singh Bisht ◽  
Sadab Khan ◽  
...  

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.

2020 ◽  
Vol 16 (2) ◽  
pp. 107-111
Author(s):  
Sanjana Raj Kumari ◽  
Neetu Adhikaree

Background: Candida albicans remains the most common and are responsible for various clinical infections ranging from mucocutaneous infection to life threatening invasive diseases. But recent epidemiological data shift from C.albicans to non albicans Candida species and also increased resistance to antifungal drugs made the scenario a serious concern. Methods: A total of 156 Candida isolates from various clinical specimens received in the department of Microbiology were taken up for the study over a period of one year i.e. from March 2019 to February 2020. The Candida were grown on Sabouraud dextrose agar to be  evaluated for colony  appearance, macroscopic examination, Gram staining, germ tube, urea hydrolysis etc. The Candida isolates were speciated by using CHROMagar medium. Antifungal susceptibility testing was performed as recommended by Clinical and Laboratory Standards Institute (CLSI) M44-A document. Results: The isolation of non albicans Candida (54.5%) predominated over Candida albicans (45.5%). Non albicans Candida isolated were Candida tropcalis 40(25.6%), Candida krusei 21(13.4%), Candida glabrata 17(10.8%) and Candida dublinensis 07(4.4%) each. Candida species were all susceptible to Amphotericin B, followed by fluconazole (67.4%), miconazole (51.9%) and ketoconazole (22.5%). Conclusions: The accurate species identification of Candida is important for the treatment because not all species respond to the same treatment and also because of the increasing antifungal resistance. CHROMagar is a convenient and rapid method of identification of Candida species specially in resource limited poor settings.   Keywords: antifungal susceptibility testing; Candida albicans; CHROMagar; non albicans Candida


Author(s):  
Parvez Anwar Khan ◽  
Nazish Fatima ◽  
Haris Manzoor Khan ◽  
Midhat Ali Khan ◽  
Asim Azhar ◽  
...  

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.


2018 ◽  
Vol 22 (04) ◽  
pp. 400-403 ◽  
Author(s):  
Khaled Ali ◽  
Mahmood Hamed ◽  
Hameda Hassan ◽  
Amira Esmail ◽  
Abeer Sheneef

Introduction Otomycosis is a common problem in otolaryngology practice. However, we usually encounter some difficulties in its treatment because many patients show resistance to antifungal agents, and present high recurrence rate. Objectives To determine the fungal pathogens that cause otomycosis as well as their susceptibility to the commonly used antifungal agents. Additionally, to discover the main reasons for antifungal resistance. Methods We conducted an experimental descriptive study on 122 patients clinically diagnosed with otomycosis from April 2016 to April 2017. Aural discharge specimens were collected for direct microscopic examination and fungal culture. In vitro antifungal susceptibility testing was performed against the commonly used antifungal drugs. We tested the isolated fungi for their enzymatic activity. Results Positive fungal infection was found in 102 samples. The most common fungal pathogens were Aspergillus and Candida species, with Aspergillus niger being the predominant isolate (51%). The antifungal susceptibility testing showed that mold isolates had the highest sensitivity to voriconazole (93.48%), while the highest resistance was to fluconazole (100%). For yeast, the highest sensitivity was to nystatin (88.24%), followed by amphotericin B (82.35%), and the highest resistance was to terbinafine (100%), followed by Itraconazole (94.12%). Filamentous fungi expressed a high enzymatic ability, making them more virulent. Conclusion The Aspergillus and Candida species are the most common fungal isolates in otomycosis. Voriconazole and Nystatin are the medications of choice for the treatment of otomycosis in our community. The high virulence of fungal pathogens is owed to their high enzymatic activity. Empirical use of antifungals should be discouraged.


Author(s):  
Falguni Sharma ◽  
Ved Prakash Mamoria ◽  
Ekadashi Rajni Sabharwal ◽  
Richa Sharma

Background: Candida species are among the most common fungal pathogens. They are ubiquitous yeasts found on plants and form the microbiota of the alimentary tract of mammals and the mucocutaneous membranes in humans. Methods: A total of 90 clinical samples were collected from Mahatma Gandhi Medical College & Hospital, Jaipur over a period of one year. Primary identification is done by the direct smear examination by Gram’s staining and KOH mount and then further sub-cultured on SDA media.  Results: Out of 90 clinical specimens collected, most common form of Candidiasis seen was Candiduria type followed by blood cultures, swab, Endotracheal tube, sputum and Bronchialveolar lavage. The maximum number of patients were found in the age group of 21-30 years, followed by 51-60 years. Out of 90 patients, 48 (53.3%) were males and 42 (46.6%) were females. C. tropicalis (44.4%) was the predominant species followed by C. albicans and other species of Candida. Among 90 samples, 32% were Candida albicans and remaining 68% were Non albicans Candida species. Conclusion: The study found that C. tropicalis was sensitive against Micafungin & Caspofungin, showing a 100% sensitivity. Candida albicans showed 100% sensitivity against Flucytosine.


Author(s):  
Rajani Singh ◽  
Rajesh K. Verma ◽  
Sunita Kumari ◽  
Amit Singh ◽  
Dharmendra P. Singh

Background: Candida species are component of normal flora of human beings. Candidiasis is the commonest fungal disease affecting mucosa, skin, nails and internal organs. A variety of predisposing factors are known to cause candidiasis either by altering balance of normal microbial flora of the body or by lowering the host defence.Methods: A total of 90 specimens submitted in the department of microbiology were included in this study.  Identification of Candida species as well as antifungal sensitivity testing was performed with Vitek®2 compact (Biomerieux France) using Vitek2 cards for identification of yeast and yeast like organisms (ID-YST cards). Antifungal susceptibility testing was performed using Vitek2 fungal susceptibility card (AST YS01) kits respectively.Results: The distribution of the clinical samples were urine 53 (58.9%), sputum 14 (15.5%), blood 10 (11.1%), nail 6 (6.7%) and high vaginal swab 7 (7.8%). Among 90 clinical isolates, species obtained were C. tropicalis 53 (59%), C. albicans 23 (25.5%), C. glabrata 6 (6.7%), C. parapsilosis 4 (4.4%), C. krusei 2 (2.2%), C. pelliculosa 1 (1.1%), C. famata 1 (1.1%).Conclusions: Infections caused by non-candida albicans species have increased. Identification of Candida species and their antifungal susceptibility are important for the treatment of hospitalized patients with serious underlying disease.


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