Identification Of Candida Species Research Articles

PROFILING AND SPECIATION OF CANDIDA SPECIES BY USING HICHROME AGAR FROM VARIOUS CLINICAL AND POSTMORTEM SAMPLES IN LIVESTOCK AND POULTRY

Animal Candidiasis is associated with oral and upper respiratory disease, pyothorax, ocular lesions, intestinal disease and urocystitis in dog and cats and causes arthritis in horses and mastitis and abortion in cattle. The present study was undertaken to determine the prevalence of Candida species among various clinical and post mortem samples of livestock and poultry. All samples were collected using aseptic precautions. After receiving in the Central University laboratory, the samples were inoculated onto both Blood agar and MacConkey agar, XLD agar and SDA agar and plates were incubated at 37 oC for 24 hours aerobically. The colonies appeared as smooth, pasty, opaque, white or beige were suspected as Candida colonies and Gram stain was done for confirmation. The speciation of the Candida isolates was performed by inoculating it on Hicrome Candida differential agar. The Hicrome agar was prepared as per the manufacturer’s instructions and incubated at 37 o C for 24 hours aerobically. The antibiotic sensitivity test was performed with Highrome agar plate. The pure culture of Candida albicans were streaked in hichrome agar plate and antibiotic disc were placed in appropriate distance and incubated at 37 oC for 24 hours aerobically. Biofilm study of yeast was performed with Sterile 96-well polystyrene plates which were inoculated with 200 µl bacterial suspension (105 CFU/ml) in BHI medium and incubated at 37 o C for 24 hrs without shaking. Species identification of Candida was done by the morphology and color of the colonies. The Candida albicans produce light green colonies, C. tropicalis metallic blue colonies, C.krusei produces purple fuzzy colonies, and C. glabrata white to cream-colored colonies. Out of 298 Candida isolates, C. Albicans was the most common species in 210 (70.46%) strains. The remaining 88 (29.5%) strains showed Non-albicans Candida. Out of 88 Non-albicans Candida isolates, Candida isolates, 20 were C. tropicalis (23%), 28 were C. glabrata (32%), 18 were Candida parapsilosis (20%) and 22 were C. krusei (25%) respectively (Table 1). Out of 298 isolates from oronasal swab (HVS), the most common species was C. Albicans followed by C. tropicalis, C. glabrata, Candida parapsilosis and C. krusei. Among the 16 urine samples, the most common species was C. Albicans followed by C. tropicalis, C. glabrata, and C. krusei were isolated.

Profiling of potential pathogenic candida species in obesity.

The aim of the current study was gut profiling of culturable Candida species and their possible pathogenic potential to asses role in obesity. This case control study includes stool samples from 75 obese individuals and 50 controls. Isolation and identification of various Candida species was carried out by standard microbiological techniques. For pathogenic profiling, extracellular enzymatic assays, biofilm forming ability and resistance to azole were analyzed. Culturable gut profiling identified comparative higher abundance and diversity of Candida species among obese compared to controls. The most abundant specie among both groups was C.kefyr. A comparatively higher pathogenic potential as more hydrolases expression was detected in C.kefyr, C.albicans and Teunomyces krusei from obese group. Majority isolates from obese group were strong biofilm formers (47.1%) compared to control group (35.4%) suggesting it as strong risk factor for obesity. Fluconazole resistance was highest among C.kefyr (51%) followed by Teunomyces krusei and C.albicans. All the isolates from different species were voriconazole sensitive except C.kefyr displaying a 4.2% resistance in obese group only. A significant association of dominant colonizing species with meat, fruit/vegetable consumption and residence area was present (p<0.05). The presence of hydrolytic enzymes in gut Candida species showed strong association with protein's degradation and enhanced pathogenicity. C.kefyr and Teunomyces krusei has emerged as potential pathogen showing increased colonization as result of protein rich and low carb diet. Thus presenting it as a bad choice for weight loss in obese individuals.

Diagnostic Value of The Real-Time PCR Test for The Identification of Candida Species in Oral Rinse Solutions

Diagnostic Value of The Real-Time PCR Test for The Identification of Candida Species in Oral Rinse Solutions

Broad-spectrum antifungal activity of Phyllanthus niruri leaves tested against Candida species

Introduction: The emergence of resistant pathogenic microorganisms against conventional antimicrobials has become a global concern. To combat new and re-emerging infectious illnesses, new antimicrobial agents with different chemical structures and novel modes of action are required. Therefore, this study evaluated ethanolic extracts of Phyllanthus niruri for their antimicrobial activities against Candida species isolated from different clinical samples. Materials and Methods: This involved the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method for the identification of Candida species. The ethanolic extraction of P. niruri leaves was examined. The agar well diffusion method was used to determine the antifungal activity of the leaf extracts against standard American Type Culture Collection strains as well as clinical isolates of Candida species. Results: Using PCR-RFLP, Candida tropicalis was found to be the most prevalent species of Candida, followed by Candida albicans, Candida glabrata, Candida krusei and Candida parapsilosis. The ethanol extract of P. nirui leaves showed good activity against all the clinical and standard strains of Candida which were comparable to the standard drug fluconazole. The activity of P. niruri against C. albicans was highest followed by C. parapsilosis, C. tropicalis, C. glabrata and C. krusei at a concentration of 100 mg/ml. Conclusion: The findings of this study support the use of P. niruri plant to treat Candida infections, particularly fluconazole-resistant Candida species.

Species Identification of Candida Isolates from Critically Ill Patients by Rapid Commercial and Genotypic Methods

Species Identification of Candida Isolates from Critically Ill Patients by Rapid Commercial and Genotypic Methods

Phenotypic Characterization of Candida species in Tertiary Care Hospital of Eastern Nepal

Background: Candida albicans is one of the most frequently isolated yeast in clinical laboratories and studies have shown that it accounts for up to 80% of the yeast recovered from the site of infection. Candida species have emerged as significant opportunistic fungal pathogens and the conventional methods of yeast identification are reported to be cumbersome with delayed diagnosis and initiation of treatment. Thus rapid identification and speciation of Candida species is essential in clinical laboratories.&#x0D; Materials and Methods: A hospital based cross sectional study was carried out in the department of microbiology, Nobel medical college from January 2020 to December 2020. Approval was acquired from the Institutional Review Committee. Various clinical specimens were obtained and identification as per the standard microbiological procedures. Data were analyzed by SPSS, version 20.&#x0D; Results: A total of 62 Candida species were isolated out of which 65% were from male and 35% were from female patients. Candida albicans was found to be the most common species with 68%. The highest incidence was seen in the age group below 20 years and 21 – 40 years with 32.25% cases each followed by 41-60 years with 20.96% cases. Among 62 specimens, urine samples yielded the highest number of Candida species 48.38% followed by sputum samples with 29.03% Candida species. High vaginal swab (HVS) yielded 12.9% Candida species and blood samples yielded 9.67% Candida species.&#x0D; Conclusion: Candida albicans is still the most significant clinically but other non albicans are also emerging significant pathogens and warrant routine discrimination in clinical laboratories.

Identification of Candida Species Using Phenotypic and Molecular Methods Isolated from Women Infected with Vulvovaginal Candidiasis in Maysan, Iraq

Vulvovaginal candidiasis (VVC) caused by Candida spp. is a serious health that primarily affects women of childbearing age, accounting for 15–25 % of vaginitis patients. There have been few studies on the VVC in Maysan province/Iraq. Thus, the aim of this study was the phylogenetic and molecular identification of Candida spp. Isolated from women with VVC in Maysan/Iraq. A total of 100 samples were taken from women of reproductive age attending the Maysan Maternity Hospital. The cultures were positive for 45 (45%) and six Candida species, including; Candida albicans (44.4%), Candida glabrata (17.8%), Candida dubliniensis (15.6%), Candida parapsilosis (11.1), Candida krusei (6.7%) and Candida Kefyr (4.4%). The colors of colonies of tested Candida on CHROMagar Candida confirmed our isolates. C. albicans and Candida dubliniensis showed capability to form chlamydospores and germ tubes and grow in the presence of cycloheximide. C. dubliniensis and C. parapsilosis showed no growth at 45°C. The majority of tested Candida species revealed 9%-100% identity with many reference strains in GenBank.

Evaluation of Candida colonization index, molecular identification, and antifungal susceptibility pattern of Candida species isolated from critically ill pediatric patients: A single-center study in Iran.

Given the high mortality rate of invasive candidiasis in hospitalized pediatric patients, it is crucial to establish a predictive system to achieve early diagnosis and treatment of patients who are likely to benefit from early antifungal treatment. This study aimed to assess the Candida colonization index, species distribution, and antifungal susceptibility pattern of Candida strains isolated from pediatric patients with high Candida colonization index (CI). This study was carried out at the Children's Medical Center in Tehran-Iran. In total, 661 samples were collected from 83 patients. The Candida CI was calculated according to the descriptions of previous studies. The isolates were identified using polymerase chain reaction-based techniques. The Clinical and Laboratory Standard Institute protocol M60 was used to conduct the antifungal susceptibility test. A colonization index greater than 0.5 was confirmed in 29 cases (58% of positive samples) with two children developing candidemia. Candida albicans (n=53, 49.5%) was the most common Candida species in patients with CI > 0.5. Except for acute lymphoblastic leukemia, no risk factors were linked to a high index in colonized children (P > 0.05). Twelve isolates (7.01%) were multi-azole resistant with high MICs against both isavuconazole and ravuconazole and seven strains (4.09%) were echinocandins resistant. In pediatric intensive care units, patients are at risk of fungal infection, particularly candidemia. In this study, more than half of the children with positive yeast cultures had CI > 0.5, and 6.8% developed candidemia.

Species distribution and susceptibility profiles of oral candidiasis in hematological malignancy and solid tumor patients.

Oral colonization and infection by Candida species are common in cancer patients receiving chemoradiotherapy, which has significantly increased in recent years. This study aimed to evaluate the frequency, distribution, and antifungal susceptibility profiles of Candida species isolates in patients with hematological malignancy and solid tumors. This study was conducted on a total of 45 cancer patients undergoing treatment with concurrent chemoradiotherapy within 2019-2020. The identification of Candida species was accomplished based on conventional examination and molecular assays. The minimum inhibitory concentrations were determined based on the guidelines of Clinical and Laboratory Standards Institute. The highest prevalence rates of oral candidiasis were observed in patients with chronic lymphoid leukemia (24.4%) and lymphoma (20%). The majority of the patients had oral candidiasis caused by non-albicans Candida species (64.4%). The results of the multiplex PCR for the identification of Candida glabrata, Candida nivariensis, Candida bracarensis, and species-specific Candida parapsilosis complex showed that all isolate amplification products at 397 bp and 171 bp were related to C. glabrata and C. parapsilosis, respectively. There was a significant difference in the Candida species distribution between the hematological malignancies and solid tumors patients. The results of MIC showed that clotrimazole, voriconazole, and caspofungin were the most effective antifungal drugs against oral non-Candida albicans isolates. An understanding of the epidemiology of oral candidiasis among hematological malignancies and solid tumors patients is currently imperative to guide optimal empirical treatment strategies for affected patients.

Identification of Candida species in faeces of children with Autism Spectrum Disorder (ASD) carbohydrate and noncarbohydrates diets

Increased colonization of Candida, especially C. albicans can occur in children with ASD and cause the severity of symptoms. One of the triggers for increased colonization in ASD children is the consumption of carbohydrates. This study aimed to identify Candida species in the faeces of ASD children who diet and nondiet carbohydrates from schools with special needs in Jember, East Java. The research design is a true experimental laboratory. The sample consisted of 26 ASD children and 13 healthy children as controls, with different subjects calculated using the Krejcie and Morgan formula. The test samples were identified for fungi by examining germ tube morphology, chlamydospores, and Candida species and compared with controls. The results showed differences in Candida species in the two test groups. Species C. albicans, C. dubliniensis, and C. tropicalis were found in almost all the faeces of ASD children with noncarbohydrates diet. The species C. parapsilosis, and C. albicans were found in a small proportion of the faeces of ASD children's carbohydrate diet. In contrast, the species found in the control group were C. albicans, C. dubliniensis, C. parapsilosis, and C. glabrata. In conclusion, carbohydrate consumption can affect the Candida species in the faeces of children with ASD.

Identification of Candida Species Isolated from Oral Candidiasis in Cancer Patients using PCR-RFLP in Sulaimani, Iraq

Identification of Candida Species Isolated from Oral Candidiasis in Cancer Patients using PCR-RFLP in Sulaimani, Iraq

“Antifungal Susceptibility Pattern of Oropharyngeal Candidiasis in Cancer Patients”

Introduction: Fungal infections like oral candidiasis is prevalent in cancer patients as their immune systems were compromised.Material and Methods: 377 cancer patients who were clinically diagnosed with oropharyngeal candidiasis were included in the study. Isolation and identification of Candida species was based on standard microbiological procedures. CLSI (2021) recommendations were followed when determining antifungal susceptibility.Results: Among the total 377 cases included, the highest number of instances was reported in those aged 41 to 50 years (30.23%). Candida albicans (21.98%) was the most frequent followed by Candida tropicalis (18.84%), Candida prapsilosis (17.80%). Monomicrobial growth was observed in 77.63% patients whereas polymicrobial growth was observed in 22.36% patients. Candida albicans (24.59%) and Candida tropicalis (20.49%) were the most frequent isolates among patients who underwent chemotherapy while Candida albicans (40%) and Candida Parapsilosis (26.66%) were the most frequent isolates among patients undergoing radiotherapy. Miconazole was found to be more susceptible than Fluconazole, Itraconazole, Clotriconazole among the antifungals.Conclusion: Due to the risk of a systemic infection, it is important to recognise candidiasis as soon as possible for the clinical management of seriously unwell cancer patients. It may also aid the clinician in selecting antifungals for empirical treatment.

Comparative evaluation of prevalence and phenotypic variations of Candida species in patients of oral lichen planus and oral lichenoid lesions with healthy individuals - A prospective microbiological study.

Candida isolates might exaggerate the development and advancement of oral lichen planus (OLP) alone or together with other factors. There is a differing pathogenic potential of various Candida species. Since Candida species isolated from OLP and oral lichenoid lesions (OLL) have shown to be resistant to commonly used antifungal agents, identification of Candida species may play a pivotal role in its successful clinical management. The aim of the study was to evaluate and compare the prevalence and phenotypic variations of Candida species in patients of OLP and OLL with healthy controls. This prospective microbiological study was conducted in the institution using indirect microscopic examination. The sample comprised of 40 clinicohistopathologically diagnosed cases of the study group (OLP and OLL) and 40 cases of control group (healthy individuals). The data collected was statistically analyzed using the Chi-square test and Fisher's exact test with the SPSS 20.00 software. The prevalence of Candida albicans was higher in the control group (28.10%) as compared to the study group (24.60%) and this difference was statistically significant. An increased frequency of non C. albicans species was seen in the study group, in decreasing order of Candida glabrata (40.70%), Candida tropicalis (22.20%), Candida krusei (22.20%) and Candida guilliermondii (3.70%), as compared to the control group. Non C. albicans species were the predominant pathogens associated with the study (OLP + OLL) group. It is important to identify the infecting strains of Candida because isolates of Candida species differ widely, both in their ability to cause infection and also in their susceptibility of resistance to antifungal agents. Thus, phenotypic speciation of Candida is emerging as a necessary trend to highlight the need of administering appropriate antifungal therapy.

P433 Identification of Candida species isolated from hospitalized patients with candiduria

Poster session 3, September 23, 2022, 12:30 PM - 1:30 PM Background and objectivesThe incidence of candiduria caused by Candida spp. has increased in recent years, particularly in hospitalized patients. Candiduria is most commonly caused by C. albicans; however, an increase in the prevalence of non-albicans species has been observed during last decades. This study aimed at molecular identification of Candida species isolated from candiduria in hospitalized patients.MethodsThis cross-sectional study was conducted on 530 hospitalized patients in two hospitals in the Mazandaran Province, Iran. Midstream urine specimens were collected and then cultured on CHROMagar Candida medium. Molecular identification of common Candida species was carried out using the polymerase chain reaction-restriction fragment length polymorphism method after enzymatic digestion with MspI. C. albicans and Candida parapsilosis species complexes were identified by amplification of the HWP1 and intein-containing vacuolar ATPase precursor genes, respectively.ResultsThe frequency of candiduria was estimated at 14% among hospitalized patients. Of 74 samples positive for candiduria, 65 (87.8%) were isolated from females. The most common predisposing factor to candiduria was diabetes (n = 36; 48.6%). The most frequent isolates were C. albicans complex (n = 44; 59.4%), followed by C. glabrata (n = 16; 21.6%), C. tropicalis (n = 10; 13.5%), C. krusei (n = 3; 4%), and C. parapsilosis (n = 1; 1.3%).ConclusionBased on the results, the conventional and molecular methods produced similar results for the identification of Candida species. However, accurate identification of Candida spp. requires the use of molecular techniques such as PCR-RFLP, HWP1, and intein-containing vacuolar ATPase precursor genes. Nevertheless, chromogenic methods such as CHROMagar Candida can be used for the diagnosis of Candida spp. in laboratories with limited resources.

P025 A study on candiduria in neonates and infants from a tertiary care center, North India.

Poster session 1, September 21, 2022, 12:30 PM - 1:30 PMObjective Candida albicans is the major cause of fungal UTI in neonates and infants but nowadays incidence of other species of Candida is also increasing, and these are mostly multidrug resistant. It is, therefore, important to determine the causative Candida species in fungal UTI for appropriate management. This study was undertaken to determine the Candida species distribution in UTI along with susceptibility patterns and outcomes in infants and neonates admitted to various wards and intensive care units (ICUs) of our hospital. The incidence rate of candiduria in ICUs was also assessed.MethodUrine samples were collected from infants and neonates presented in pediatric and neonatal ICUs and clinical wards with a clinical suspicion of candiduria. Infants at risk of invasive candidiasis were also included in the study. Identification of Candida species was done by Gram's staining, germ tube test, chlamydospore formation on corn meal agar, color of colonies on CHROMagar, and confirmed by Matrix Assisted Laser Desorption-Time of Flight (MALDI-TOF). Antifungal susceptibility was performed by using the Broth microdilution method as per the latest CLSI guidelines (M27-A3/M27-S4).ResultUrine samples were received from 219 infants, and Candida was isolated from samples from 52 infants (isolation rate 23.75%), of which 30 were admitted to pediatric or neonatal ICU and 22 in the wards. The incidence rate of candiduria in ICU was 3.25%. Candida albicans was the most frequently isolated species from the samples of infants in the wards (13/22 ie, 59%), while Candida tropicalis was most frequently isolated from samples of infants in the ICUs (13/30 ie, 43.34%). Candida glabrata was the least commonly isolated species and was only encountered in the ICU. The species distribution of isolates is given in Table 1. There was no discrepancy between the results of conventional methods of identification and MALDI-TOF.Antifungal susceptibility was performed for 18 randomly selected isolates. All were found to be susceptible to caspofungin, micafungin, itraconazole, voriconazole, fluconazole, and amphotericin B. MIC distribution for various isolates is given in Table 2.ConclusionHigh index of suspicion of candiduria is necessary for early diagnosis of fungal UTI and initiation of antifungal treatment, especially in critically ill infants requiring intensive care. Species other than C. albicans are also encountered more frequently nowadays and these species often have higher MICs for commonly used antifungal drugs, which may lead to delayed or failed response to routine antifungal therapy and necessitate prolonged use and or higher doses of antifungals. Identification of Candida isolates at species level along with analysis of the susceptibility patterns is therefore important for successful outcomes in candiduria in neonates and infants.

P478 Identification of clinical Candida isolates using maldi-tof-ms and their antifungal susceptibility profile—a study from tertiary care pediatric hospital in noida

Poster session 1, September 21, 2022, 12:30 PM - 1:30 PM Introduction Candida species are ubiquitously present as commensals in the human body. In immunocompromised and hospitalized patients, they can cause various types of infections ranging from cutaneous to bloodstream infections and hence are capable of causing morbidity and mortality in patients1.Increase in the prevalence of infections caused by non-albicans Candida (NAC) has been reported in many parts of the world.Candidemia incidence varies from 0.24 to 34.3 patients/1000 ICU admissions and with a high mortality rate of 35%–75% early antifungal treatment is essential for survival2.Accurate species identification is important for the treatment of the Candida infections as the NAC continues to be increasingly documented with decreased susceptibility to antifungal agents3.ObjectivesTo identify Candida species in various clinical samples using Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS)To study in vitro antifungal susceptibility profiles of the identified candida species, using VITEK-2 compact system (Biomeriux, France)Material and MethodsThe study was conducted in Department of Microbiology during the period of August 2018 to August 2021.Various clinical samples of pediatric patients from both genders from outpatient and inpatient departments suspected for candidiasis were included in the study.Initially the samples, with probable yeast were inoculated on Saboraud Dextrose agar (SDA) with chloramphenicol incubated at 370C.Gram stain was done from the culture growth look for yeast cells.The MALDI-TOF MS-based identification of all yeast isolates to the species level was performed according to …… (malti name and software version) using the ethanol (EtOH)/formic acid (FA) extraction protocol.Antifungal susceptibility was performed using the VITEK-2 system (bioMerieux Pvt. Ltd., France). The following antifungal drugs were tested: fluconazole, caspofungin, micafungin, amphotericin B, flucytosine, and voriconazole.ResultsTotal 86 candida isolates were obtained during the study period. Male: female ratio of samples was 1.6:1.A total of 67% of clinical samples were from neonatal age group i.e upto 28 days of birth.Majority of clinical samples (57%) were received from NICU.The antifungal susceptibility testing showed 100% sensitivity of C. albicans isolates to fluconazole, caspofungin, micafungin, amphotericin B, flucytosine, and voriconazole. Candida pelliculosa, C. parapsilosis showed 93% and 73% sensitivity to fluconazole whereas all three C. krusei isolates were resistant to fluconazole, and flucytosine.A total of 100% sensitivity was observed for amphotericin B and micafungin by all isolates as shown in Table 1.ConclusionRapid identification of Candida species using Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) as a reliable and rapid technique for Candida species identification as candida is an important cause of neonatal sepsis and sepsis related mortality.Antifungal susceptibility testing is indispensable, keeping in mind the rising trend in non-albicans over C. albicans for appropriate treatment and better outcome in neonates.SourcesRajeevan S, Thomas M, Appalaraju B. Characterisation and Antifungal susceptibility pattern of Candida species isolated from various clinical samples at a tertiary care centre in South India. Indian J Microbiol Res 2016; 3(1): 53-57.Chakrabarti A, Sood P, Rudramurthy SM, Chen S, Kaur H, Capoor M, Chhina D, Rao R, Eshwara VK, Xess I, Kindo AJ. Incidence, characteristics and outcome of ICU-acquired candidemia in India. Intensive care medicine. 2015 Feb;41(2):285-95.Page BT, Kurtzman CP. Rapid identification of Candida species and other clinically important yeast species by flow cytometry. J Clin Microbiol 2005; 43:4507-14

Analysis of resistance and sensitivity of 1 200 strains of vulvovaginal candidiasis in China to five common antifungal drugs

Objective: To test the antibiotic susceptibility of vulvovaginal candidiasis pathogenic strains to 5 antifungal drugs commonly used in clinic. Methods: A total of 1 200 vulvovaginal candida patients from 23 gynecological and family planning outpatient departments in China were enrolled. Their vaginal secretions were collected for candida strain isolation and species identification. According to Clinical and Laboratory Standards Institute (CLSI) M27-S3, the sensitivity of 1 200 strains to clotrimazole, fluconazole, miconazole, itraconazole and nystatin was tested. Results: (1) The sensitivity and resistance of 1 200 vulvovaginal candidiasis pathogens to 5 antifungal drugs were statistically different (χ2=3 513.201, P<0.01). (2) All strains had higher sensitivity to nystatin [99.92% (1 199/1 200)], followed by miconazole [92.25% (1 107/1 200)] and clotrimazole [87.17% (1 046/1 200)]. All strains had higher resistance to fluconazole [69.17% (830/1 200)], while itraconazole was 50.83% (610/1 200). (3) There was no significant difference between candida albicans and non-candida albicans in drug sensitivity to nystatin (P=0.315) and miconazole (P=0.425). (4) Candida albicans and non-candida albicans showed different sensitivity to clotrimazole, fluconazole and itraconazole, respectively. Compared with non-candida albicans, candida albicans showed higher sensitivity to clotrimazole [susceptibility rate: 73.01% (165/226) vs 90.45% (881/974); P<0.001] and higher resistance to fluconazole [resistance rate: 50.88% (115/226) vs 73.41% (715/974); P<0.001]. Although the drug sensitivity of itraconazole was not high, the susceptibility rate of candida albicans to itraconazole was slightly higher than that of non-candida albicans [37.68% (367/974) vs 23.89% (54/226)], and the drug resistance rate was lower [49.28% (480/974) vs 57.52% (130/226)]. Conclusions: The sensitivity of 1 200 strains of candida to 5 antifungal drugs is significantly different, the sensitivity rate of nystatin, miconazole and clotrimazole are higher, but the resistance rate of fluconazole and itraconazole are higher. The sensitivity of candida albicans and non-candida albicans to the same drug is also significantly different. It is suggested that in clinical diagnosis and treatment, we should pay attention to the identification of candida and drug sensitivity test, so as to select antifungal drugs rationally.

ABNORMAL VAGINAL DISCHARGE IN REPRODUCTIVE AGE GROUP WOMEN WITH SPECIAL IMPLICATION TO ANTIFUNGAL SUSCEPTIBILITY OF CANDIDA SPECIES

Introduction And Background: Vaginal discharge is a common complaint in reproductive age group women2. Vaginal discharge is one of the common reasons in women of reproductive age group seeking gynecological consultation. It is the second most common clinical problem after menstrual disorders. Globally, it is estimated that one in ten women will present with vaginal discharge in the course of one year and approximately, ten million office visits each year are attributed to vaginal discharge complaints. The prevalence of vaginal discharge in India is estimated to be 30%3. Ÿ Abnormal vaginal discharge predisposes to significant morbidity to the women in the form of pelvic inflammatory disease, infertility, endometriosis, cuff cellulitis, urethral syndrome, pregnancy loss, and preterm labour.5 Ÿ Certain conditions such as prolonged use of combined oral contraceptive, pregnancy, malnutrition, diabetes, neutropenia, prolonged antibiotic therapy, candida become pathogenic and causes candidiasis.8 Ÿ Isolation, identification, characterization, and susceptibility of candida species became critical management of fungal infections.9 Need For The Study: The study was done to emphasize the role of laboratory investigations in patients with vaginitis, as presumptive clinical diagnosis alone can lead to false interpretation and treatment mismanagement. TheMethods: present study is a cross sectional observational study conducted from January 2019 to February 2020 for about a period of one year among 300 women aged 15-49 years with vaginal discharge attending gynecology OPD, Government Maternity Hospital, Tirupati. This study included 300 subjects with a mean age of 30.4 ± 7.26 years. Nearly halfResults: of (49.33%) our study population was aged between 25 to 34years, a majority (47%) of women had bacterial vaginosis, followed by Candida in 39.33%, trichomonas vaginalis in 14.33%, mixed infections in 6.67% and 6% with no organisms. Among Candida species, 48.31% of participants had candida albicans, 23.73% had candida tropicalis, 19.49% had candida krusei, and 8.47% had candida glabrata, and of them 38.33% participants had voriconazole sensitivity, 32.33% participants had ketoconazole sensitivity, 26% participants had clotrimazole sensitivity, and 21.33% participants had fluconazole sensitivity. Among 118 candida infected 106 (89.83%) participants came for follow-up, of which symptoms subsided in 90 (84.91%) participants. In conclusion, our study with 300 women patients complaining ofConclusion: vaginal discharge found a majority of them belonging to the sexually active age group. Vaginal discharge was more prevalent in lower economic status and rural areas. Bacterial vaginosis was the most common and frequent etiology, followed by Candida. TV was the least common etiology for vaginal discharge.

A six-year hospital-based surveillance study on burden of esophageal candidiasis in Gangtok, Sikkim.

Esophageal candidiasis once thought to be restricted amongst immunocompromised patients is being increasingly reported among non-immunocompromised individuals. It is debilitating and if not treated well may cause chronic long-lasting infections. The objective of this study was to identify the various species of Candida causing esophageal candidiasis and analyse their antifungal susceptibility pattern. This was an observational, prospective study. Total of 108 patients who attended the Gastroenterology Department of Sir Thutob Namgyal Memorial Hospital, Govt of Sikkim, Gangtok, India between July 2012 - May 2018 were included in the study. They had complaints of upper gastrointestinal disturbances and chronic dyspeptic symptoms that required an endoscopy. Esophageal biopsy and brushings were taken and were transported to Microbiology Department. They were subjected to microscopic observation, fungal culture on Sabourauds dextrose agar. Preliminary species identification was done by chlamydospore formation and growth characteristics on CHROMagar Candida. Species confirmation and antifungal susceptibility testing was done on VITEK 2 system at Microbiology Department, Kasturba Medical College and Hospital, MAHE, Manipal, Karnataka, India. A total of 108 patients were screened among which 73 samples were positive for Candida species and species identification and antifungal susceptibility was performed. Forty fiveisolates were found to be C. albicans, 8 were C. glabrata, 4 were C. tropicalis, 3 were C. lusitaniae 2 were C. krusei, 2 were C. lipolyticaand 1 was C. parapsilosis. Eight isolates could not be identified and were recorded as Candida spp. C. albicans isolates were predominantly sensitive strain with susceptibility of 95% for both amphotericin B and fluconazole and 100% for caspofungin. C. glabrata showed high resistance to fluconazole with one isolate showing intermediate resistance to caspofungin. Upper gastrointestinal symptoms even in non-immunocompromised patients need to be screened by endoscopy to rule out esophageal candidiasis. With the emergence of drug resistant non albicans Candida species diagnostic testing laboratories should include Candida species identification and antifungal susceptibility testing facility to provide effective patient care.

Multilocus Sequence Typing and Antifungal Susceptibility of Candida albicans Isolates From Milk and Genital Tract of Dromedary Camel.

Multilocus sequence typing (MLST) was used to study the genetic diversity and population structure of 48 Candida albicans (C. albicans) isolates from the udder or genital tract of apparently healthy or diseased camels. This study aimed also to determine the frequency of C. albicans isolates in the genital tract and udder of healthy or diseased female dromedary camels. A total of 240 mature dromedary camels (230 females and 10 males) were categorized based on the clinical examination of gentile tract and udder into five groups [fertile females (n = 70), infertile females (n = 115), healthy udder (n = 15), mastitis (n = 30), and fertile males (n = 10)]. Swabs were collected from male and female genital tracts of dromedary camels and milk samples were collected from healthy and diseased udders. C. albicans was isolated from 20% of the samples. The frequency of isolation was significantly higher (p < 0.00001) in disease camels (75%) compared with apparently healthy camels (25%). Most of C. albicans was isolated from infertile female genitalia (62.50%) which was significantly higher than that isolated from fertile female genitalia (16.67%). Multilocus sequence (MLS) analysis identified seven different diploid sequence types (DSTs) including DST2, DST50, DST62, DST69, DST124, DST142, and DST144. The most frequently identified DTS was DST69 (13/48) which significantly higher (p ≤ 0.05) than DST2, DST62, and DST124. The frequency of identification of DST50, DST142, and DST 144 was significantly higher (p ≤ 0.05) than DST62. DST62 and DST124 were isolated only from diseased camels. DST62 was isolated only from mastitic milk. DST124 was isolated only from infertile female genitalia. The percentage of DST50 and DST 142 was significantly higher in diseased camels (infertile females) than in the apparently healthy ones (fertile females). DST2 and DST50 were isolated only from female genitalia of apparent health and diseased camels. The C. albicans isolated from diseased camels had significantly higher biofilm formation, hydrophobicity, phospholipase, proteinase, and hemolysin activities compared with the isolates from apparent healthy camels. All isolates were sensitive to amphotericin B, itraconazole, micafungin, posaconazole and voriconazole. In conclusion, the present study represents the first molecular typing of C. albicans in samples isolated from milk and the genital tract of the dromedary camel. MLST is a useful tool for studying the epidemiology and evolution of C. albicans. Early identification of Candida species and attention to Candida virulence factors and their antifungal susceptibility patterns is very important for establishing strategies to control and/or prevent candidiasis by novel therapeutic management. Amphotericin B, itraconazole, micafungin, posaconazole, or voriconazole can be efficient in treatment of candidiasis.