P377 Study of the prevalence of candidemia and its antifungal susceptibility pattern in a tertiary care hospital

Abstract

Poster session 3, September 23, 2022, 12:30 PM - 1:30 PMObjectivesStudy of the prevalence of candidemia and its resistance pattern in a tertiary care hospital.MethodsRetrospective observational studyStudy period—January 1, 2020-December 31, 2021Blood culture bottles (aerobic and anaerobic) were received in the laboratoryIncubated in BacT Alert 3D (Biomerieux) for 5 daysAfter flagging positive, a direct gram stain was prepared from the culture bottle and informed to the clinician. Culture plating was done on Blood agar and Mac Conkey Agar which were incubated for 18-24 h at 37°C.After 24 h, growth was obtained on the culture plate and identification was done by using MALDI-TOF MS (Biomerieux) and Susceptibility Testing was done using VITEK 2 Compact (Biomerieux).Antifungal sensitivity testing was done using VITEK 2 Compact for fluconazole, voriconazole, caspofungin, micafungin, amphotericin B, and flucytosine.ResultsDuring the study period, 18 235 blood culture bottles were received, and 1652 blood culture bottles were flagged positive. The most common organism causing bloodstream infection belonged to Burkholderia spp. Candida sp (4%) was found to be the sixth most common organism causing bloodstream infection.Among Candida spp most common isolate was C. tropicalis 42% followed by C. parapsilopsis 21%, C. albicans 21%, and C. auris 12%, and the least isolated species was C. glabrata 4%.Maximum number of Candida spp were isolated from intensive care units.Susceptibility testing was given by VITEK 2 compact for all Candida spp except for Candida auris.The isolated Candida spp showed the least susceptibility to fluconazole (resistant rate R 30.6%) as compared to micafungin, caspofungin, flucytosine, and amphotericin B (R 13.9%, 13.9%, 22.2%, and 5.6%,) respectively. Candida glabrata showed less sensitivity toward caspofungin as compared to other antifungals.Conclusion Candida spp. are a part of the normal flora of healthy hosts but are also found to be a major cause of invasive fungal infections which is now found to be one of the leading causes of mortality in hospitalized patients. The emergence of unusual and relatively unknown Candida species as nosocomial pathogens with increasing treatment failure, emphasizes the need to isolate and identify all species and to start early definitive treatment according to the susceptibility pattern reported to decrease mortality and morbidity rates.