ISOLATION, IDENTIFICATION AND ANTIFUNGAL SUSCEPTIBILITY TESTINGOF CANDIDA ISOLATES FROM VARIOUS CLINICAL SPECIMENS AT A TERTIARY CARE HOSPITAL, WESTERN RAJASTHAN

Abstract

Background: Candida spp is a member of the normal flora of the skin, mucous membrane and gastrointestinal tract. Candida continues to be leading cause of morbidity and mortality in large population of immunocompromised and hospitalized patients. Invasive Candidiasis due to non-albicans candida has been on the rise in last few years. This study aims to Spectate Candida using chromogenic medium.The emerging pathogens are resistant to conventional antifungal therapy. Objective: To identify the various species of candida isolated from different clinical specimens and to compare the susceptibility pattern of these isolated species towards different antifungal agents. Methods: All Candida isolates recovered from various clinical samples during the period from September 2017 and august 2018 were studied., These isolates were subjected to grams stain, germ tube test and inoculation on commercially available CHROM agar (HiMedia India). Results: A total of 155 Candida species were isolated from the different clinical specimens of suspected candida infection cases. Most of the isolates obtained were from urine samples 93 (60%) followed by blood 26(16.77%). Non albicans Candida were isolated at a higher rate 101 (65.16%) than Candida albicans 54 (34.84%) . Among 101 non C. albicans, C. tropicalis 55 (35.48%) was the most common species followed by 19 (12.26%) C. parapsilosis. Among all species of Candida commonest isolate was C. tropicalis 55(35.48%) followed by C. albicans 54(34.83%). Candida species from various samples were high resistant to itraconazole (72.26%) followed by fluconazole(70.92%), voriconazole (68.39%) and ketoconazole (57.42%)while there was minimum resistance to amphotericin-B (20%).This study emphasizes the need for monitoring local epidemiologic data and antifungal susceptibility pattern of candida isolates for proper treatment. Conclusions: Along with Candida albicans, non-albicans candida spp like C. tropicalis, parapsilosis, C. krusei and C. glabrata are increasingly being isolated from clinical samples. CHROM agar is a simple, rapid and inexpensive method for identification of such species. Characterization to species level helps to identify species which might be intrinsically resistant to commonly used antifungal agents.