Distribution and susceptibility to various antifungal agents among blood stream Candida isolates from Neonatal intensive care unit

Abstract

Background: During the past several decades, there has been a steady increase in the frequency of isolation of Candida spp. from blood stream infections from NICU worldwide. Furthermore, monitoring programs have detected an increase in the prevalence of infections caused by non albicans Candida (NAC). NAC are reported to be intrinsically resistant and less susceptible to empirically used azoles like Fluconazole. Thus speciation and antifungal susceptibility testing become imperative for these isolates. Objective: To study the trend in species distribution and antifungal susceptibility pattern among blood stream Candida strains isolated from neonatal intensive care patients was the aim of the study. Method: Susceptibility testing of clinically significant Candida isolates to various antifungal was performed by E-test in accordance with manufacturer instructions. The results obtained were analyzed and compared. Results: The most frequently isolated species was Candida tropicalis (52.83%) followed by Candida parapsilosis (16.98%), Candida albicans (9.4%), Candida glabrata (9.4%), Candida krusei (7.5%) and Candida guilliermondii (3.77%). Overall sensitivity of 85%, 81%, 26%, and 98% respectively to Amphotericin B, Fluconazole, Itraconazole and Voriconazole was found. Conclusion: The study shows the clinical significance and mycological shift of Candida species in blood culture of the neonatal population with a predominance of NAC species. Voriconazole showed an excellent activity and can be used in empirical treatment for candidemia rather than Fluconazole.