Susceptibility Patterns Of Candida Species Research Articles

English

PURPOSE: Fungal infections with candida species are an important cause of morbidity and mortality1. Situation is further worsened by increasing resistance to antifungal drugs 2.The objective of this study was to evaluate antifungal susceptibility pattern of Candida species to fluconazole by disc diffusion and agar dilution method and compare these two methods as far as fluconazole is concerned. MATERIAL & METHODS: Between January 2006 to December 2006, 119 Candida species were isolated from 225 sputum samples of patients of pulmonary tuberculosis and immunocomprised patients. RESULTS: Of the 119 Candida isolates 33 (27.73%) were Candida albicans, 32 (26.89%) were Candida gullermondi, 27 (22.68%) Candida tropicalis, 14 (11.76%) Candida pseudotropicalis, 7 (5.88%) Candida parapsilosis and 6 (5.04%) were Candida krusei. The Candida isolates were tested for fluconazole by disc diffusion method on Muller hinton agar with 2% glucose and 0.5 microgram of methylene blue 3.Amongst the 119 Candida isolates, 17 (14.28%) isolates were resistant to fluconazole by disc diffusion method. MIC done by agar dilution method using CLSI guidelines 4. Candida isolates showed growth of 15 (88 .23%) Candida strains upto 8 microgram / ml with 80% inhibition of growth whereas 2 (1.7%) isolates showed MIC upto 64 microgram/ ml. CONCLUSIONS: Candida albicans though a common species other species were isolated in significant number. The results of disc diffusion for fluconazole do not correlate with agar dilution method. To cater the need of resource constrained laboratories, it is important to have results that correspond to the clinical outcome of antifungal treatment and show co-relation to those obtained with the reference method as recommended by CLSI guidelines and also be reproducible5. Further critical studies are needed.

Antibiogram of candida species isolated from mono and multi-species oral candidal carriage using disk diffusion method

Context: Oral candidiasis is the most common oral opportunistic infection has seen in the immunocompromised patients. Apart from C. albicans the non-Candida albicans Candida species, which are less susceptible to the commonly used antifungal drugs are major etiological agent for candidiasis. Thus, the treatment strategy for candidiasis should be different in case of multiple species infection. Aims: The aim of this present study is to compare the antifungal susceptibility patterns of Candida species isolated from mono species and multiple species oral Candidal carriage. Materials and Methods: The species of Candida, isolated from mono and multiple species oral Candidal carriage of the healthy and immunocompromised patients were used for the experiment. Antifungal susceptibility test was performed by using disk diffusion susceptibility method on Methylene blue Glucose- Mueller-Hinton agar. Statistical Analysis Used: Paired student's t-test. Results: In this, present study, variability in antibiogram of Candida species isolated from mono species and the corresponding species isolated from multiple species combinations were reported. The susceptibility ranking for antifungal drugs for the strain isolated from mono species OPC (C. albicans > C.tropicalis > C. glabrata > C.krusei) and for the strains isolated from multiple species combination (C. albicans > C. glabrata > C.krusei > C.tropicalis) for mean of the five antifungal drugs combined were reported. Species of C. albicans and C. tropicalis were reported more resistant towards anti fungal agents when these present in mono-species condition, whereas; C. krusei and C. glabrata were more susceptible when these present in mono-species condition. Polyenes (amphotericin-B and nystatin) compounds were found to be most effective than azoles against Candida spp. isolated from multi-species lesions as none of the strain were shown resistant towards these drugs, conversely; a significant fraction of C. tropicalis and C. albicans isolated from mono-species lesion were shown resistant toward polyenes compound tested. Conclusions: The findings of this study shows statistically insignificant diverse antifungal susceptibility pattern of Candida species isolated from mono and multiple species Oropharyngeal Candidiasis combinations.

UP-2.025: Virulence Factors and Susceptibility Patterns of Candida Species Isolated from Patients with Obstructive Uropathy and Bladder Carcinoma

UP-2.025: Virulence Factors and Susceptibility Patterns of Candida Species Isolated from Patients with Obstructive Uropathy and Bladder Carcinoma

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.

Susceptibility patterns of Candida species recovered from Canadian intensive care units

Objective The objective of this study was to determine the speciation and susceptibility patterns of Candida species recovered from Canadian intensive care units (ICUs) during a 1-day point-prevalence study on fungal colonization/infection in Canadian ICUs. Methods and Setting Blood, urine, respiratory tract, rectal, and wound fungal cultures were performed for 357 patients present at any time during a single-day 24-hour period in 35 Canadian ICUs. Comparative in vitro activities of amphotericin B, fluconazole, itraconazole, voriconazole, posaconazole, micafungin, anidulafungin, and aminocandin were determined. Results Four hundred fifteen yeasts (409 Candida species and 6 non- Candida yeasts) were recovered. Almost 50% of the patients were found to have positive respiratory tract or rectal cultures. Candida albicans accounted for 72% of the Candida species isolated, followed by Candida glabrata (16%), Candida tropicalis (5%), Candida parapsilosis (3%), Candida krusei (2%), and other Candida species or nonspeciated isolates (2%). Minimum inhibitory concentrations (milligrams per liter) at which 90% of the strains were inhibited were 0.06 for micafungin as well as anidulafungin, 0.12 for voriconazole, 0.25 for itraconazole, posaconazole, as well as aminocandin, 1 for amphotericin B, and 4 for fluconazole. Only 4% of the isolates were resistant to fluconazole and/or itraconazole. Conclusions Candida albicans is the predominant species colonizing Canadian ICU patients. Overall, the triazoles, both older and new compounds, and the echinocandins have excellent in vitro antifungal activities against Candida species recovered from Canadian ICUs patients.

Antifungal susceptibilities of Candida spp. isolated from blood in Spain and Argentina, 1996-1999.

The aim of this study was to identify retrospectively trends in species distribution and susceptibility patterns of Candida species causing bloodstream infections in 99 medical centres (55 in Spain and 44 in Argentina) from 1996 to 1999. A total of 744 Candida isolates were sent to the mycology reference laboratories during the study period (514 to the Spanish laboratory and 230 to the Argentinian laboratory). Candida non-albicans strains caused more episodes of fungaemia than Candida albicans isolates in both Spain and Argentina. C. albicans was isolated in 30.2% (155/514) and 40.9% (94/230) of episodes in Spain and in Argentina, respectively. In addition, Candida parapsilosis was the second most commonly isolated pathogen (36.4%). Candida tropicalis caused 13.7% of infections and Candida glabrata 7.4%. The amphotericin B MIC was <or=1 mg/L for 97.5% of isolates, and 8.3% of strains had decreased susceptibility to flucytosine. Regarding susceptibility to azole agents, 9.9% (74/744) and 21.9% (163/744) exhibited decreased susceptibility to fluconazole and itraconazole, respectively. For Candida species, some marked differences were found between countries, and decreased susceptibility to azole agents was detected significantly more frequently (P < 0.05) among Argentinian isolates of C. albicans, C. parapsilosis and C. tropicalis. These findings reinforced the need for continued surveillance programmes to analyse the factors that may have an influence on candidaemia incidence. Susceptibility patterns were obtained by means of the proposed reference procedure for antifungal susceptibility testing of the European Committee on Antibiotic Susceptibility Testing (EUCAST). Excellent interlaboratory agreement was achieved for MICs for quality control strains noted in Spain and in Argentina (intraclass correlation coefficient of 0.97), indicating that the EUCAST procedure is a reliable methodology for susceptibility testing.