English

Abstract

BACKGROUND: Candidemia remains as one of the major cause of morbidity and mortality in health care setting. Over the last two decades, the proportion of blood stream infection (BSI) due to non-albicans Candida (NAC) species has increased. Several NAC spp. are inherently resistant to commonly used antifungal drugs. The increased isolation rates of NAC spp. and a gradual shift in the antifungal susceptibility profile underlines the need of early and accurate diagnosis of infecting Candida spp. along with antifungal susceptibility testing for selecting the most appropriate antifungal agent for therapy. AIM: The Aim of the present study was to investigate the distribution pattern of Candida spp. isolated from candidemia patients and evaluate its antifungal susceptibility pattern. SETTING AND DESIGN: The present study was conducted in the department of Microbiology for a period of six years (January 2006 to December 2011) which included, 194 Candida spp. isolated from the cases of candidemia. MATERIALS AND METHODS: Candida isolates were speciated by conventional techniques and HiCandida identification kit. Antifungal susceptibility test was performed using two disc diffusion methods. Clinical details and risk factors were recorded and analyzed. RESULTS AND CONCLUSIONS: Isolation of NAC spp. was significantly higher than Candida albicans. The most important risk factor associated with candidemia was intensive care unit stay, followed by diabetes and HIV infection. Azole resistance was more in NAC species as compared to C. albicans . The early and accurate diagnosis of infecting Candida spp. along with antifungal susceptibility testing plays a pivotal role in preventing morbidity and mortality associated with Candida BSI. Disc diffusion technique for antifungal susceptibility using glucose methylene blue Mueller- Hinton (GM-MH) agar was found to be simple, cost effective and sufficiently accurate for the routine testing of antifungal susceptibility of Candida spp. in resource constrained