Non albicans Candida species: its isolation pattern, species distribution, virulence factors and antifungal susceptibility profile

Abstract

Background: The change in epidemiology and antifungal susceptibility has generated interest of Clinical Microbiologists in identification of Candida up to species level along with antifungal susceptibility pattern. Non-albicans Candida (NAC) has emerged as an important opportunist pathogen. Extracellular hydrolytic enzymes are one of the important virulence attributes of Candida species. Aims & Objective: The present study aimed to determine the species distribution, virulence factors and antifungal susceptibility profile of NAC spp. isolated from various clinical specimens. Material and Methods: Speciation of Candida was done by assessing the germ tube formation, assimilation and fermentation of sugars and colony color on HICHROM Candida agar. In-vitro extracellular hydrolytic enzymes production in NAC spp. was assessed. Antifungal susceptibility testing of the isolates was performed by Hicomb minimum inhibitory concentration (MIC) test. Results: Majority of the isolates were obtained from urine sample (35.6%). C. tropicalis (29.4%) was the major isolate. Maximum extracellular hydrolytic enzymes activity was seen in C. tropicalis. A total of 79 (27.3%) isolates were resistant to fluconazole. Amphotericin B resistance was noted in 17 (5.8%) isolates. Conclusion: NAC spp. cannot be overlooked as mere containment or non-pathogenic commensals as most of them show reduced susceptibility to commonly used antifungal drugs. Extracellular hydrolytic enzymatic activity of NAC Spp. would be an important tool to prove the relation between the infective species of Candida and infection.