Emergence Of Non-albicans Candida Research Articles

Emergence of Nonalbicans Candida in Neonatal Septicemia and Antifungal Susceptibility: Experience from a Tertiary Care Center

Aims:To know the distribution and antifungal susceptibility pattern of Candida species in neonatal septicemia cases.Materials and Methods:In a prospective analysis blood samples from 825 clinically suspected cases of neonatal septicemia, collected aseptically, were cultured to look for the role of Candida spp. in septicemia. Candida isolates were speciated by germ tube test, Hi-CHROME agar, sugar fermentation, and sugar assimilation tests using standard protocol. All the Candida isolates were tested for antifungal susceptibility to fluconazole by the Disk Diffusion (DD) method and broth micro dilution-minimum inhibitory concentration (BMD-MIC) method using NCCLS guidelines.Results:Isolation rate of Candida from neonatal septicemia cases was 8.1%. Most common isolate was C. tropicalis (61.19%), followed by C. albicans (19.40%), C. glabrata (11.94%), C. parapsilosis (5.97%) and C. guillermondii (1.49%). Low birth weight and previous antibiotic prophylaxis was found in 100% cases. Crude mortality rate was 50.1%. By DD method, 95.53% of the Candida isolates were sensitive to fluconazole. A discrepancy between DD method and BMD-MIC method was noted in 4.47% strains. One isolates each of C. tropicalis, C. albicans, and C. glabrata showed discrepancy.Conclusion:Nonalbicans Candida has emerged as an important cause of neonatal septicemia. Routine susceptibility testing of Candida isolates by DD method should be confirmed by BMD-MIC method. Fluconazole can be used as empirical therapy for neonatal candidemia at our center.

The changing spectrum of candidemia in oncology patients: therapeutic implications.

Infections caused by Candida spp. are frequent and serious in oncology patients. Over the past decade, the introduction of azole antifungals as prophylactic agents, and other factors have caused a shift in the species of Candida that cause infection. During the period under review (June 1999 to June 2000), several studies have been reported that confirm the impact of antifungal prophylaxis and the emergence of non-albicans Candida spp. as pathogens. Moreover, laboratory studies to determine the antifungal susceptibilities and virulence properties of non-albicans Candida spp. have enabled the formation of microbe-specific management strategies. More of these studies will be necessary as we enter an age in which multiple antifungal compounds will become available for clinical use.