Prevalence of Candida species and their Susceptibility to Triazoles in Clinical Isolates from a Tertiary Care Hospital

Abstract

In the recent past, the incidence of Candidiasis has witnessed a concerning upsurge, resulting in a significant healthcare challenge. These infections are further exacerbated by factors like the widespread use of broad-spectrum antimicrobials, chemotherapy-induced neutropenia, and the presence of medical devices. The present study is designed to address the critical need for identifying the Candida species responsible for clinical infections and assessing their susceptibility to key antifungal drugs Fluconazole, Voriconazole, and Itraconazole. Two hundred clinical samples from Rohilkhand Medical College & Hospital, Bareilly were analyzed. Using Vitek-2 Compact (Biomerieux, France), the Candida spp. and the antifungal drug sensitivities were identified for Fluconazole and Voriconazole. E-test was done to identify Itraconazole sensitivity. This study found that C. albicans accounted for 21.5% while Non-albicans Candida (NAC) constituted 78.5%. Prolonged medication was the most common factor making susceptible for Candidiasis (43.5%), followed by indwelling biomedical devices (23%), Diabetes mellitus (16%), surgical causes (5.5%), trauma (5%), pregnancy (5%), and HIV (2%). Antifungal susceptibility testing showed that 68.5%, 72%, and 69.5% of Candida spp. isolates were sensitive to Fluconazole, Voriconazole, and Itraconazole, respectively. In conclusion, non-albicans Candida infections are increasing due to predisposing conditions, and some of these species are inherently resistant to the routinely used antifungal drugs. The study emphasizes the importance of identifying Candida spp. and their susceptibility to antifungals. This can limit the indiscriminate use of antifungal drugs, aid in selecting appropriate treatments, and reduce treatment costs, hospital stays, and patient morbidity and mortality.