Comparison of Susceptibility of Various Candida Species Isolated From Neonatal Septicaemia to Voriconazole and Fluconazole

Abstract

Background: Candida species are known to be the most common fungal pathogens isolated from blood cultures of neonates. Recent reports from our country indicates trend towards an increasing prevalence of non-albicans candidemia. Candida species possess a number of virulence factors which enable them to cause hematogenously disseminated infections in susceptible hosts with increased morbidity and mortality. Objectives:To know the prevalence of candidemia in neonates and their antifungal susceptibility pattern. Materials and Methods: Blood samples from suspected cases of neonatal septicemia were subjected to culture, incubated for 7 days and subcultures performed. Culture yielding pure growth of Candida were included for the study and identified by standard methodology. Antifungal susceptibility was performed towards fluconazole and voriconazole by disc diffusion method on Muller-Hinton agar with 2% glucose and methylene blue. Result: Among 1583 blood cultures 80(5%) candida isolates were obtained. The various species isolated were C.pseudotropicalis 34(42.5%), C.tropicalis 22(27.5%), C.albicans 12 (15%) C.guillermondii 6(7.5%), C.parapsilosis 4(5%) and C.krusei 2(2.5%). Fluconazole susceptibility was observed in 56(70%) sensitive, 18 (22.5%) Susceptible-Dose Dependent (SDD) and 6(7.5%) resistant and all were sensitive to voriconazole. Conclusion: In this study non albicans candida was the common isolate & they showed decreased resistance to Fluconazole. In neonatal septicemia speciation & antifungal susceptibility may help in management.