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

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 60Candida 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 krusei3%. 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.

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Prevalence of Candidiasis Infection & Antifungal Susceptibility Pattern at Tertiary Care Hospital, Jaipur

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2020/v32i2830865 ◽

2020 ◽

pp. 8-13

Author(s):

Falguni Sharma ◽

Ved Prakash Mamoria ◽

Ekadashi Rajni Sabharwal ◽

Richa Sharma

Keyword(s):

Candida Albicans ◽

Candida Species ◽

Fungal Pathogens ◽

Antifungal Susceptibility ◽

Tertiary Care ◽

Clinical Samples ◽

Care Hospital ◽

Medical College ◽

Number Of Patients ◽

Gandhi Medical College

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.

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Rapid identification and susceptibility pattern of various Candida isolates from different clinical specimens in a tertiary care hospital in Western Uttar Pradesh

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20173542 ◽

2017 ◽

Vol 5 (8) ◽

pp. 3466

Author(s):

Rajani Singh ◽

Rajesh K. Verma ◽

Sunita Kumari ◽

Amit Singh ◽

Dharmendra P. Singh

Keyword(s):

Candida Species ◽

Antifungal Susceptibility ◽

Tertiary Care ◽

Underlying Disease ◽

Vaginal Swab ◽

The Body ◽

Clinical Samples ◽

Care Hospital ◽

Human Beings ◽

Sensitivity Testing

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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Isolation and identification of candida species from various clinical samples in a tertiary care hospital

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20173554 ◽

2017 ◽

Vol 5 (8) ◽

pp. 3520 ◽

Cited By ~ 2

Author(s):

Vignesh Kanna B. ◽

Amar Kumar G. ◽

Swapna M. ◽

Joshy M. Easow

Keyword(s):

Candida Albicans ◽

Candida Species ◽

Secondary Infection ◽

Tertiary Care ◽

Vaginal Swab ◽

Clinical Samples ◽

Care Hospital ◽

Inexpensive Method ◽

Candida Spp ◽

Isolation And Identification

Background: Candida spp is a member of the normal flora of the skin, mucous membrane and gastrointestinal tract. They are endogenous opportunists which cause secondary infection in individuals with underlying immunocompromised conditions. Candidiasis is a common fungal disease in humans. An increase in the prevalence of non-albicans species has been noted during the last decades because of increasing use of azoles. This study aims to Spectate Candida using chromogenic medium.Methods: A total of 50 Candida isolates from various clinical samples were included in the study. These isolates were subjected to gram's stain, germ tube test and inoculation on commercially available CHROM agar (HiMedia India).Results: In current study majority of isolates were from high vaginal swab (34%) followed by sputum (28%), urine (18%), pus from surgical sites and others constituted to 20%. Candida albicans (51%) was the most common candida species, followed by C. tropicalis (25%), C. krusei (16%), C. glabrata (6%) and C. dubliniensis (1%).Conclusions: Along with Candida albicans, non-albicans candida spp like C. tropicalis, C. krusei, C. glabrata, and C. dubliniensis are increasingly being isolated from clinical samples. CHROM agar is a simple, rapid and inexpensive method for identification of such species. Characterization to species level helps to identify species which might be intrinsically resistant to commonly used antifungal agents.

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Speciation of Candida using CHROMagar from various clinical specimens and their antifungal susceptibility pattern at a tertiary care hospital.

Journal of College of Medical Sciences-Nepal ◽

10.3126/jcmsn.v16i2.29896 ◽

2020 ◽

Vol 16 (2) ◽

pp. 107-111

Author(s):

Sanjana Raj Kumari ◽

Neetu Adhikaree

Keyword(s):

Candida Albicans ◽

Candida Species ◽

Susceptibility Testing ◽

Antifungal Susceptibility ◽

Tertiary Care ◽

Epidemiological Data ◽

Antifungal Susceptibility Testing ◽

Antifungal Drugs ◽

Care Hospital ◽

Clinical Specimens

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

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CHARACTERISATION AND ANTIFUNGAL SUSCEPTIBILITY PATTERNS OF CANDIDA SPECIES ISOLATED IN TERTIARY CARE HOSPITAL IN NORTH INDIA.

10.36106/ijsr/9333492 ◽

2021 ◽

pp. 7-8

Author(s):

Meenakshi Sharma ◽

Chaudhary BL

Keyword(s):

Candida Albicans ◽

Candida Species ◽

Tertiary Care Hospital ◽

Antifungal Susceptibility ◽

Tertiary Care ◽

Diffusion Method ◽

Individual Species ◽

Care Hospital ◽

Clinical Specimens ◽

Susceptibility Patterns

Candida is usually considered a commensal with the potential to cause opportunistic infections ranging from supercial mucosal infections to lifethreatening invasive infections. This study was aimed to determine antifungal susceptibility patterns of Candida species isolated from various clinical specimens from a tertiary care hospital. Isolation and identic Material and Methods: ation of Candida species were done by morphological examination, pseudohyphae, and chlamydospore production on cornmeal agar, germ tube test, and HiCrome Candida differential agar. The antifungal susceptibility of Candida strains was performed by the disk diffusion method as per the CLSI M44-A2 protocol. A Result: total of 96 Candida species were isolated from various clinical specimens. The isolation rate was more in the older age group and female patients(52%). Most frequently isolated from urine 41.67% followed by sputum 19.79%, Blood 16.67%, and least from vaginal swab 2.08%. Four species of Candida were isolated among them Candida albicans was most common 59.37% followed by Candida prapsilosis and Candida krusei 15.62%, and Candida tropicalis 9.37%. In antifungal susceptibility testing, Itraconazole was the most sensitive drug and Fluconazole was the least sensitive one with only 58.33% susceptibility among individual species. Concussion: Urinary tract infection was common due to Candida albicans, and Itraconazole was the most susceptible drug.

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Characterisation and Isolation of Candida Species from ICU Patients in Nobel Medical College Teaching Hospital, Biratnagar

Journal of Nobel Medical College ◽

10.3126/jonmc.v5i1.15777 ◽

2016 ◽

Vol 5 (1) ◽

pp. 61-65

Author(s):

Bigu Kumar Chaudhari ◽

Ganesh K. Singh ◽

Kamal Prasad Parajuli ◽

Kewal Shrestha ◽

Dharmendra Shah

Keyword(s):

Candida Albicans ◽

Teaching Hospital ◽

Candida Species ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Antifungal Drugs ◽

Clinical Samples ◽

Care Hospital ◽

Sensitivity Testing ◽

Medical College

Background Fungi have emerged as major causes of human diseases. Intensive Care Units (ICU), harbor almost all the risk factors for opportunistic fungal infections. Among these, Candida infections are very common with recent trends being rise in the non-Candida albicans (NCA) species along with an increase in resistance of these species to antifungal drugs. Increament in invasive Candidasis during last three decades have been reported in several studies, among all Candida species the Candida albicans is considered as the most common infectious agent the other non-albicans like C. Tropicalis, C. glabrata, C. parapsilosis C. krusei, and C. dubliniensis were raised as infectious agents. The aim of current study is to characterize the candida species from the clinical specimens of patients admitted in the ICU of Tertiary Care hospital in Eastren Nepal and to perform their antifungal susceptibility.Material and Methods The study was carried out in the tertiary care hospital Nobel Medical College and Teaching Hospital Biratnagar Nepal over a period of 6 monthsbetween September 2015 to February 2016. The following techniques were employed to characterize the isolates in the study – Gram’s stain, culture on Sabouraud’s Dextrose Agar, Germ Tube test, morphology in Cornmeal Agar and chromogenic agar media, sugar fermentation and sugar assimilation tests, and the results were interpreted by using standard protocols.Results Out of 50 candida isolates from different clinical samples including 37 blood samples, 9 urines and 4 Endo Tracheal (ET) tube, the most common species was C.albicans (44%) followed by C.tropicalis (26%), C.Glabrata (18%), C.Parapsilosis (08%), C.Krusei (02%), and C.Dubliniensis(02%).Conclusion The purpose of the study is to show the value of species isolation, identification and antimicrobial sensitivity testing of the ICU & NICUs patients.Journal of Nobel Medical CollegeVolume 5, Number 1, Issue 8, January-July 2016, 61-65

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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 Candida infection in Covid-19 pandemic: A study from a tertiary care center in Central India

Asian Journal of Medical Sciences ◽

10.3126/ajms.v12i10.38528 ◽

2021 ◽

Vol 12 (10) ◽

pp. 3-7

Author(s):

Saurabh Jayant ◽

Kamlesh Patel ◽

Prachi Priya ◽

Abhilasha Niti Verma ◽

Bharat Singh ◽

...

Keyword(s):

Candida Species ◽

Antifungal Susceptibility ◽

Tertiary Care ◽

Vaginal Swab ◽

Antifungal Drugs ◽

Candida Infection ◽

Preliminary Treatment ◽

Care Hospital ◽

Opportunistic Fungi ◽

Wide Range

Background: Corona virus disease 2019 (COVID-19) infections may be associated with a wide range of bacterial and fungal co-infections. Candida and mucor are the common fungus encountered during this pandemic. Candida is one of the commonly encountered opportunistic fungi that cause superficial mucosal infections usually, but can invade tissue and produce life threatening infections. Candida species recognized as one of the major agent of hospital Acquired (nosocomial) fungal infections. Keeping this in background the current study was conducted. Aims and Objective: To estimate the prevalence of candida infection in tertiary care hospital of Indore. Materials and Methods: The present study was done in the period of one and half year. During this period all received clinical specimens like urine, sputum; high vaginal swab and pus suspected for fungal infection from Covid as well as non-Covid patients were processed according to standard protocol. The specimen was subjected to preliminary tests like wet mount, Gram’s stain, culture on sabourads dextrose agar (SDA) and Hichrome agar, germ tube test, sugar assimilation test and culture on Cornmeal agar (dalmau technique) for candida species were done. For statistical analysis Chi-square test was performed and p ≤ 0.05 was considered statistically significant. Results: The prevalence of Candidiasis was 0.86%. Non-albicans candida (65.9%) isolates was more than Candida albicans (34.07%). Among non-albicans species, C. tropicalis was 27.4% followed by C. glabrata 16.29%, C. krusei 15.55%,C. parapsilosis 5.92% and C. lusitenia 0.74% were the major isolates. Males were affected more than the females. In both the genders maximum patients were from the age group of >60 years. Maximum number of Candida isolates was from blood followed by urine, pus, sputum, vaginal swab and aural swab. Most common risk factors for candidiasis noted in this study was diabetes mellitus in both Covid as well as non-Covid patients. Conclusion: Non albicans candida are gradually increasing in India. Speciation of candida play an important role in preliminary treatment because different species is intrinsically resistant to different antifungal drugs and have different antifungal susceptibility pattern.

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ISOLATION, IDENTIFICATION AND ANTIFUNGAL SUSCEPTIBILITY TESTINGOF CANDIDA ISOLATES FROM VARIOUS CLINICAL SPECIMENS AT A TERTIARY CARE HOSPITAL, WESTERN RAJASTHAN

International Journal of Advanced Research ◽

10.21474/ijar01/13807 ◽

2021 ◽

Vol 9 (11) ◽

pp. 809-814

Author(s):

Sandeep Arora ◽

◽

Smita Kulshreshtha ◽

Usha Verma ◽

Prameshwar Lal ◽

...

Keyword(s):

Candida Albicans ◽

Candida Species ◽

Antifungal Agents ◽

Large Population ◽

Antifungal Susceptibility ◽

Clinical Samples ◽

Care Hospital ◽

Susceptibility Pattern ◽

Candida Spp ◽

Clinical Specimens

Background: Candida spp is a member of the normal flora of the skin, mucous membrane and gastrointestinal tract. Candida continues to be leading cause of morbidity and mortality in large population of immunocompromised and hospitalized patients. Invasive Candidiasis due to non-albicans candida has been on the rise in last few years. This study aims to Spectate Candida using chromogenic medium.The emerging pathogens are resistant to conventional antifungal therapy. Objective: To identify the various species of candida isolated from different clinical specimens and to compare the susceptibility pattern of these isolated species towards different antifungal agents. Methods: All Candida isolates recovered from various clinical samples during the period from September 2017 and august 2018 were studied., These isolates were subjected to grams stain, germ tube test and inoculation on commercially available CHROM agar (HiMedia India). Results: A total of 155 Candida species were isolated from the different clinical specimens of suspected candida infection cases. Most of the isolates obtained were from urine samples 93 (60%) followed by blood 26(16.77%). Non albicans Candida were isolated at a higher rate 101 (65.16%) than Candida albicans 54 (34.84%) . Among 101 non C. albicans, C. tropicalis 55 (35.48%) was the most common species followed by 19 (12.26%) C. parapsilosis. Among all species of Candida commonest isolate was C. tropicalis 55(35.48%) followed by C. albicans 54(34.83%). Candida species from various samples were high resistant to itraconazole (72.26%) followed by fluconazole(70.92%), voriconazole (68.39%) and ketoconazole (57.42%)while there was minimum resistance to amphotericin-B (20%).This study emphasizes the need for monitoring local epidemiologic data and antifungal susceptibility pattern of candida isolates for proper treatment. Conclusions: Along with Candida albicans, non-albicans candida spp like C. tropicalis, parapsilosis, C. krusei and C. glabrata are increasingly being isolated from clinical samples. CHROM agar is a simple, rapid and inexpensive method for identification of such species. Characterization to species level helps to identify species which might be intrinsically resistant to commonly used antifungal agents.

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Species identification of Candida isolated from clinical specimens in a tertiary care hospital

Bangabandhu Sheikh Mujib Medical University Journal ◽

10.3329/bsmmuj.v9i1.28940 ◽

2016 ◽

Vol 9 (1) ◽

pp. 20 ◽

Cited By ~ 2

Author(s):

Lsmet Nigar ◽

Shirin Tarafder ◽

Rehana Razzak Khan ◽

S. M. Ali Ahmed ◽

Ahmed Abu Saleh

Keyword(s):

Candida Albicans ◽

Candida Species ◽

Tertiary Care ◽

Clinical Manifestations ◽

Common Species ◽

Blood Stream ◽

Care Hospital ◽

Emerging Pathogens ◽

Predisposing Factor ◽

Clinical Specimens

Background: Candida species are responsible for various clinical manifestations from mucocutaneous overgrowth to blood stream infections especially in immunocompromized situations. Although C. albicans is the most prevalent species, high incidence of non-albicans Candida species with antifungal resistance are emerging which is posing a serious threat to the patients care.Objective: This study aimed to isolate and identify different species of Candida from different clinical specimens. Methods: A total of 100 different clinical specimens were studied of which 35 were oral swab, 28 were high vaginal swab, 15 were urine, 14 were nail, 04 were bronchoalveolar lavage and peritoneal fluid were 04. Among 100 clinical specimens, Candida isolates were identified in 64 specimens. Isolation of Candida species was done by primary culture in SDA. Subsequent identification of species were performed by germ tube test, subculture in chromogenic agar medium and carbohydrate assimilation test with commonly used twelve sugars.Results: Out of 64 isolated Candida species, Candida albicans were 51.56% and the non-albicans Candida species were 48.44%. The most prevalent Candida species was C. albicans 33 (51.53%) followed by C. tropicalis 17 (26.56%). C. glabrata 4 (6.25%), C. parapsilosis 4 (6.25%), C. krusei 3 (4.68%) and C. guilliermondii 2 (3.2%). One of the isolated Candida species was unidentified.Conclusion: Though Candida albicans was found as the most common species, but non-albicans Candida species are appearing as emerging pathogens as well. Exposure to chemotherapy appeared to be the commonest predisposing factor for Candida infection followed by indwelling urinary catheter in situ for prolong period.

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