P028 To Study the Susceptibility of Caspofungin in Azole Resistant Candidemia of High-Risk Neonates of Nicu by E-STRIP (MIC) Method andTime to Think for Preventive Measures

Abstract

Poster session 1, September 21, 2022, 12:30 PM - 1:30 PMBackgroundThe rise in azole-resistant candidemia among bloodstream infections of critically ill neonates had made treatment choices difficult for neonate ICU clinicians. There is gross evidence of an epidemiological shift to non-albicans Candida. Newer class of antifungal drugs especially Echinocandins (caspofungin) came into real-time practice in azole-resistant Candida causing sepsis.Objective1) To study the azole-resistance in the Candida isolates from the blood sample.2) To develop preventive strategies and protocols.Material and MethodsA total of 222 blood samples collected from NICU from the high-risk neonates with suspected sepsis, who were admitted in the study period and were processed and were evaluated as per the Standard Mycological techniques followed by antifungal susceptibility done according to CLSI guidelines (M44-A2 and M60).ResultsOf 222 blood samples 58 (26.12%) were pure isolates of Candida, of which 17 (29.31%) were C. albicans and 41 (70.68%) were non-albicans Candida. In which C. glabrata (30/41), C. tropicalis (4/41), C. parapsiliosis (6/41), C. krusei (1/41). Maximum resistance was found against fluconazole 39/58 (67.24%) by disc diffusion method. These isolates are maintained and checked for caspofungin and fluconazole susceptibility by the e-strip method in under process (results will be disclosed later).ConclusionThis study concludes that fluconazole resistance is on the rise. A newer class of drugs Echinocandins have come to the rescue. Strict infection control strategies, appropriate preventive, and therapeutic measures such as prophylactic antifungal use, and a restrictive policy of antibiotic use should be implemented by the health care workers and officials in NICU. Care should be taken for emerging multi-drug resistant species like C. auris.