SUSCEPTIBILITY OF CANDIDA SPECIES TO ANTIFUNGAL DRUGS IN WESTERN INDIA

Abstract

Introduction: The increase in candidaemia is associated with high mortality. A shift has been observed in the relative frequency of each Candida spp. isolated from blood. Options of the antifungal drugs available for treatment of systemic & invasive candidiasis are restricted to polyenes, allylamines, azoles and recently developed echinocandin class of molecules. A rise in the incidence of antifungal resistance to Candida spp. has also been reported over the past decade. Studies on prevalence of infections and antifungal susceptibility testing are useful in deciding clinical strategies.

Aims: To do species level identification and detect resistance, if any, among Indian clinical isolates of C. albicans.

Methodology: From total 135 patients from a tertiary care hospital of Gujarat, Candida species  were  isolated  from different  clinical  specimens. The growth of Candida on Sabouraud’s dextrose agar was confirmed by Gram staining in which gram positive budding fungal cells were observed. Then its growth was examined for colony morphology on Sabouraud’s dextrose agar and chlamydospore production on Corn meal tween 80 agar. Germ tube tests and other biochemical tests like sugar fermentation, sugar assimilation and urease test were performed to identify the species of Candida. Antifungal susceptibility testing was performed by NCCLS M44-A Disc diffusion method.

Results: Out of total 135 samples, C. Albicans were isolated from 52 (38.5%). Among Non Albican Candid (NAC), Candida glabrata was 36 (26.7%) followed by Candida tropicalis 25(18.5%). C. albicans was found resistant to Fluconazole, Itraconazole and Amphotericine B in 3.8%, 3.8% and 1.9% cases respectively. For NAC, resistance of Fluconazole, Itraconazole and Amphotericine B was found in 4.8%, 3.6% and 2.4% cases respectively.