CHARACTERIZATION, VIRULENCE TESTING AND ANTIFUNGAL SUSCEPTIBILITY PATTERN OF VARIOUS CANDIDA SPECIES AT TERTIARY CARE CENTRE, AMRITSAR

Rajesh BANSAL; LOVEENA OBEROI

Abstract

IntroductionSerious fungal infections particularly Candida infection have increased in recent years as a consequence of increased immunosuppression associated with HIV infection, organ and tissue transplant and aggressive treatment for malignancies and autoimmune diseases. Present study was conducted to Characterize various Candida species isolated from various clinical samples, their virulence testing by biofilm production and antifungal susceptibility pattern.Settings and Design:A prospective observational study was conducted from September 2014 to June 2016 in the Department of Microbiology, Government Medical College, Amritsar. A total of 1230 samples with suspected Candida infections were collected and processed. A total of 313 Candida isolates from various clinical samples were taken up for the study.Materials and Methods: Samples were processed by Gram staining, KOH mount & culture on SDA and BHI agar. Isolated yeasts were identified & speciated by germ tube test, chlamydospores formation on corn meal agar, color production on CHROM agar, sugar fermentation test and sugar assimilation test. Antifungal susceptibility testing of isolates was performed as per CLSI guidelines. Biofilm production was tested by Tube method and Tissue culture plate method.Statistical analysis used: The data was statistically analysed using the statistical package for Social science (SPSS)/ 21.0 (Copyright © SPSS Inc.).Results & Discussion: Out of 313 isolates, Candida tropicalis was predominant species (46.33%) followed by Candida albicans (34.82%), C. parapsilosis (10.54%), C. glabrata (5.75%) and C.krusei (2.56%.). Maximum resistance was observed to fluconazole & ketoconazole. Antifungal resistance was found to be more in biofilm producers. In virulence testing, tissue culture plate method was found to be more sensitive than tube method for biofilm detection.Conclusion: The emergence of non-albicans Candida as major isolates in hospital settings has made it imperative to identify all yeast isolates up to species level and their antifungal susceptibility pattern for efficient treatment, prevention of development of antifungal resistance and finally, the reduction of the treatment costs.