02Oct 2019

SPECIATION AND ANTIFUNGAL SUSCEPTIBILITY PATTERN OF CANDIDA ISOLATES FROM VARIOUS CLINICAL SPECIMENS AT A TERTIARY CARE HOSPITAL, MAHARASHTRA.

  • PG Resident,Department of Microbiology, MGM Medical College and Hospital, Aurangabad, Maharashtra.
  • Professor,Department of Microbiology, MGM Medical College and Hospital, Aurangabad, Maharashtra.
  • Professor and Head,Department of Microbiology, MGM Medical College and Hospital, Aurangabad, Maharashtra.
  • PG Resident, Department of Microbiology, MGM Medical College and Hospital, Aurangabad, Maharashtra.
  • Assistant Professor, Department of Microbiology, MGM Medical College and Hospital, Aurangabad, Maharashtra.
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Introduction: Candida species are one of the major human opportunistic pathogen. Various factors like indiscriminate use of antibiotics, AIDS and other immunosuppressive conditions have led to significant rise in Candida and other fungal infections. Emergence of Antifungal resistance has further complicated the situation. Material and Method: This prospective study was conducted at a multispecialty tertiary care centre in Maharashtra for 18 months. A total of 164 Candida isolates from various clinical specimens were analysed. Repeat isolates from same patient were excluded. Species identification and antifungal susceptibility testing was done using Vitek 2 system. Results: Out of 164 Candida isolates, Candida albicans 67(40.8%) was the most common species followed by Candida tropicalis 48(29.3%), Candida parapsilosis 16(9.7%), Candida famata 15(9.1%), Candida ciferrii 6(3.6%), Candida lusitaniae 5 (3%). From Urine, Sputum, Pus and Bronchoalveolar lavage fluid Candida albicans was most common isolate; while non-albicans Candida species were most commonly isolated from Blood, Endotracheal secretion. Candida isolates showed maximum resistance to Voriconazole (9.7%), followed by Flucytosine (5.5%), Amphotericin B (2.4%), Caspofungin (2.4%), Micafungin (2.4%) and Fluconazole (1.2%).


  1. Bailey and Scott?s Diagnostic Microbiology (14th edition; page 827).
  2. Arendrup, M. C., Fuursted, K., Gahrn-Hansen, B., Jensen, I. M. Knudsen, J. D., Lundgren, B., Schonheyder, H. C. & Tvede, M. (2005). Seminational surveillance of fungemia in Denmark: notably high rates of fungemia and numbers of isolates with reduced azole susceptibility. J Clin Microbiol 43, 4434?4440.
  3. Espinel-Ingroff, A., Canton, E., Peman, J., Rinaldi, M. G. & Fothergill A.W. (2009). Comparison of 24-hour and 48-hour voriconazole MICs as determined by the Clinical and Laboratory Standards Institute broth microdilution method (M27?A3 document) in three laboratories: results obtained with 2,162 clinical isolates of Candida spp. And other yeasts. J Clin Microbiol 47, 2766?2771.
  4. Koneman?s Color atlas and textbook of diagnostic microbiology (6th Edition; page 1221).
  5. Pfaller MA, Diekema DJ, Gibbs DL, et al. Results from the ARTEMIS DISK Global Antifungal Surveillance Study, 1997 to 2007: a 10.5- year analysis of susceptibilities of Candida species to fluconazole and voriconazole as determined by CLSI standardized disk diffusion. J Clin Microbiol 2010; 48: 1366?77.
  6. Ostrosky-Zeichner L, Rex JH, Pappas PG, et al. Antifungal susceptibility survey of 2,000 bloodstream Candida isolates in the United States. Antimicrob Agents Chemother 2003; 47: 3149?54.
  7. Dannaoui E, Lortholary O, Raoux D, et al. Comparative in vitro activities of caspofungin and micafungin, determined using the method of the European Committee on Antimicrobial Susceptibility Testing, against yeast isolates obtained in France in 2005?2006. Antimicrob Agents Chemother 2008; 52: 778?81.
  8. Sachin C. Deorukhkar, Santosh Saini, and Stephen Mathew, ?Non-albicans Candida?Infection: An Emerging Threat,??Interdisciplinary Perspectives on Infectious Diseases, vol. 2014, Article ID 615958, 7 pages, 2014.?https://doi.org/10.1155/2014/615958.
  9. Wadlin JK, Hanko G, Stewart R, Pape J, Nachamkin I. Comparison of three commercial systems for identification of yeasts commonly isolated in the clinical microbiology laboratory. J Clin Microbiol 1999; 37:1967‑
  10. Crist AE Jr., Johnson LM, Burke PJ. Evaluation of the microbial identification system for identification of clinically isolated yeasts. J Clin Microbiol 1996; 34:2408‑
  11. Kaur R, Dhakad MS, Goyal R, Haque A, Mukhopadhyay G. Identification and Antifungal susceptibility testing of Candida species: A Comparison of Vitek-2 system with conventional and molecular methods. J Global Infect Dis 2016; 8:139-46.
  12. Morrell M, Fraser VJ, Kollef MH. Delaying the empiric treatment of Candida bloodstream infection until positive blood culture results are obtained: A potential risk factor for hospital mortality. Antimicrob Agents Chemother 2005; 49:3640‑
  13. Essentials of Medical Microbiology (1st edition; page no. 568).
  14. Badiee P, Alborzi A, Vojdani R, Shakiba E, Rasouli M, Ravanfar P, et al. Early diagnosis of systemic candidiasis in bone marrow transplant recipients. Exp Clin Transplant. 2010; 8(2):98?103. [PubMed: 20565365].
  15. Colombo AL, Guimaraes T, Sukienik T, Pasqualotto AC, Andreotti R, Queiroz-Telles F, et al. Prognostic factors and historical trends in the epidemiology of candidemia in critically ill patients: an analysis of five multicenter studies sequentially conducted over a 9-year period. Intensive Care Med. 2014; 40(10):1489?98. doi: 10.1007/s00134-014- 3400-y. [PubMed: 25082359].
  16. Lortholary O, Renaudat C, Sitbon K, Madec Y, Denoeud-Ndam L, Wolff M, et al. Worrisome trends in incidence and mortality of candidemia in intensive care units (Paris area, 2002-2010). Intensive Care Med. 2014; 40(9):1303?12. doi: 10.1007/s00134-014-3408-3. [PubMed: 25097069].
  17. Graf B, Adam T, Zill E, G?bel UB. Evaluation of the VITEK 2 system for rapid identification of yeasts and yeast‑like organisms. J Clin Microbiol 2000; 38:1782‑
  18. Pfaller MA, Diekema DJ. Epidemiology of invasive mycoses in North America. Crit Rev Microbiol. 2010; 36(1):1?53. doi: 10.3109/10408410903241444. [PubMed 20088682].
  19. Shokohi T, Bandalizadeh Z, Hedayati MT, Mayahi S. In vitro antifungal nsusceptibility of Candida species isolated from oropharyngeal lesions of patients with cancer to some antifungal agents. Jundishapur J Microbiol. 2011; 4(Supplement 1):S19?S26.
  20. Badiee P, Amirghofran AA, Nour MG, Shafa M, Nemati MH. Incidence and outcome of documented fungal endocarditis. Int Cardiovasc Res J. 2014 Dec; 8(4):152. doi: 25614858.
  21. Ghasemi Z, Hashemi SJ, Rezaei S, Kordbache P, Khosravi M, Mortazavi H, et al. Molecular Analysis of Candida species with Emphasis on Predisposing Factors in Cutaneous Candidiasis Patients. Jundishapur J Microbiol. 2016; 10(2):e41030. doi: 10.5812/jjm.41030.
  22. Wang H, Xiao M, Chen SC, Kong F, Sun ZY, Liao K, et al. In vitro susceptibilities of yeast species to fluconazole and voriconazole as determined by the 2010 National China Hospital Invasive Fungal Surveillance Net (CHIF-NET) study. J Clin Microbiol. 2012;50(12):3952?9. doi: 1128/JCM.01130-12. [PubMed: 23035204].
  23. Abirami?Lakshmy,?Radhika?Katragadda, J. Balaji; Speciation and antifungal susceptibility of esophageal?candidiasis?in cancer patients in a tertiary care hospital in South India; J Med Allied?Sci?2016; 6(1):29-34?DOI:?10.5455/jmas.214436.
  24. Guo-Shi Xiang, Ling-Bing Zeng, Jie-Yu Zhang, Ying Ying, Xi-Ren Deng, Xue-Fei Hu, Yan Yan,Ke-Hua Yu,1 Wei-Wen Zou, and Xiao-Tian Huang; In Vitro Antidrug Susceptibility Testing of Candida Species Isolated from Aseptic Body Fluids; Jundishapur J Microbiol. 2018 August; 11(8):e55547. Published online 2018 July 25. doi: 10.5812/jjm.55547.
  25. Kamiar Zomorodian, Azadeh Bandegani, Hossein Mirhendi, Keyvan Pakshir, Navvab Alinejhad, and Ali Poostforoush Fard; In Vitro Susceptibility and Trailing Growth Effect of Clinical Isolates of Candida Species to Azole Drugs; Jundishapur J Microbiol. 2016; 9(2): e28666. doi: 10.5812/jjm.28666
  26. Echinocandin Resistance in?Candida; David S. Perlin; Clin Infect Dis.?2015 Dec 1;?61(Suppl 6): S612?S617.?Published online 2015 Nov 5.?doi:?10.1093/cid/civ791; PMCID:PMC4643482
  27. Giri S, Kindo AJ. A review of Candida species causing blood stream infection. Indian J Med Microbiol 2012; 30:270-8.
  28. Cuenca-Estrella, T. M.?D?az-Guerra, E.?Mellado, J. L.?Rodr?guez-Tudela. Flucytosine Primary Resistance in?Candida?Species and?Cryptococcus neoformans; Eur J Clin Microbiol Infect Dis (2001) 20:276?279.

[Ishan Pandita, A.S. Wyawahare, M.V. Mulay, Tazammul Hussain and Smita Kulkarni. (2019); SPECIATION AND ANTIFUNGAL SUSCEPTIBILITY PATTERN OF CANDIDA ISOLATES FROM VARIOUS CLINICAL SPECIMENS AT A TERTIARY CARE HOSPITAL, MAHARASHTRA. Int. J. of Adv. Res. 7 (10). 244-250] (ISSN 2320-5407). www.journalijar.com


Dr. Wyawahare A.S
Professor in Microbiology

DOI:


Article DOI: 10.21474/IJAR01/9827       DOI URL: http://dx.doi.org/10.21474/IJAR01/9827


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