Antifungal Drug Resistance among Candida albicans and Non-albicans Candida Species Isolates from a Tertiary Care Centre at Allahabad

Abstract

Objective: The aim of our study was to identify the distribution of Candida species among clinical isolates and their sensitivity pattern for common antifungal drugs. Methods: This descriptive study was carried out in a tertiary care hospital in Allahabad. A total of One hundred and four Candida isolates were included in the study. Identification and speciation of the isolates were carried out by Germ-tube test, Chlamydoconidia production test, colony characterization in chromogenic agar medium, carbohydrate assimilation test and growth at 45°C. Four antifungal drugs such as Fluconazole (25 mcg), Clotrimazole (10 mcg), Nystatin (100 U) and Amphotericin-B (100 U) were tested by disk diffusion method. Descriptive statistics was used which involves the use of simple percentage and bar chart to analyze the data. In addition, Chi-square test was performed and P value was calculated. Results: Out of 104 Candida isolates, 60 (58%) were from Urine, 36 (34.5%) were from Sputum and 8(7.5%) were from blood isolates. Of the total of 104 isolates 64 (61.5%) were Candida albicans, 20(19%) Candida dubliniensis, 10 (9%) Candida tropicalis, 7(6.5%) Candida parapsilosis and 4(4%) Candida glabrata respectively. Resistance rates for commonly use antifungal drugs among the isolates are as followed Fluconazole 76 (73%), Amphotericin B 40 (38.5%), Nystatin 4(4%) and Clotrimazole 60 (58%) respectively. For Candida albicans and Candida dubliniensis most active antifungal drug was Nystatin (93%; 100% respectively). Discussion: Species level identification of Candida and their antifungal sensitivity testing should be performed routinely in all microbiology laboratories to prevent the spread of antifungal resistance.