Prevalence of non-albicans candidemia in a tertiary care hospital in Northeast India

Abstract

Background: Candidemia is gaining significance worldwide and is the fourth most common cause of bloodstream infections (BSI) with mortality ranging from 5% to 71%. Objectives: To determine the prevalence of candidemia and characterize the non-albicans candida (NAC) causing BSI. Materials and Methods: The study was conducted in the department of microbiology for a period of 2 years (January 2014-December 2015). Blood samples received were cultured in brainheart infusion broth. Subcultures were done in Sabouraud Dextrose Agar and Sabouraud Chloramphenicol Cycloheximide Agar. For identification of isolates, Gram stain, germ tube test, urea hydrolysis, cornmeal agar morphology, and sugar assimilation test were performed. Antifungal susceptibility testing was determined by Vitek 2 compact system using AST YS 06 Cards. Results: During the study period, a total of 4123 blood samples were received, of which 786 samples were positive. Among the 786 positive samples, 739 (94%) samples showed bacterial growth and 47 (6%) samples showed growth of Candida spp. The prevalence of NAC was 32 (70%) and rest 15 (30%) was Candida albicans. Most of the NAC species showed resistance to fluconazole, voriconazole, caspofungin, micafungin, and amphotericin B as compared to C. albicans. Conclusion: The study highlights the change in epidemiology in the species distribution of Candida. There is a rise in infections by NAC species as compared to those by C. albicans. Early and regular species identification and antifungal testing is necessary to decrease the mortality associated with it.