A study of candidiasis in HIV reactive patients in a tertiary care hospital, Mysore - South India

Shivaswamy, Umamaheshwari; Neelambike, Sumana M.

doi:10.4103/0378-6323.132271

Cited by 4 publications

(3 citation statements)

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“…The present study infers that NAC predominates C. albicans. C. tropicalis being the most common species reported, revealed a significant epidemiological shift compared to our previous study from 2010 to 2014 (16). The increased ratio of NAC over C. albicans reflected the rise in the incidence of NAC, but the reason for this switchover is unknown.…”

Section: Discussionmentioning

confidence: 60%

“…Various species have been isolated from multiple clinical sites. The increased incidence of candidiasis, the surge of NAC, and the change in susceptibility patterns have emphasized the need to monitor laboratory data and select the appropriate antifungal for therapy (14)(15)(16)(17). The knowledge of epidemiological surveillance on species distribution and their emerging resistance to antifungal agents can be the guide for effective management and antifungal stewardship.…”

Section: Introductionmentioning

confidence: 99%

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Retrospective analysis on distribution and antifungal susceptibility profile of Candida in clinical samples: a study from Southern India

Shivaswamy

Sumana

2023

Front. Public Health

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IntroductionCandida is one of the rising primary causes of infections connected with health care. However, their distribution and susceptibility patterns vary widely amongst different regions.MethodThe study was carried out to retrospectively analyze the distribution of Candida in various clinical samples, their species types and susceptibility, in a tertiary care hospital, in India for 4 years using the Vitek-2 database.ResultsCandida infection was identified in 751 clinical samples, and the major source of infection was found to be urine samples accounting for about 58.32%. A total of 18 different Candida species were recorded. Non-albicans Candida (NAC) 73.64% (n = 553) predominated Candida albicans 26.36% (n = 198). Candida tropicalis was found to be identified at a higher frequency followed by C. albicans, Candida glabrata and Candida parapsilosis. Candida tropicalis was the only species which were recovered from bile; Candida pelliculosa was recorded merely from blood and Candida lipolytica from urine and blood and not in any other samples. In vaginal swabs, C. albicans accounted for 63.64% (n = 14) compared to NAC 36.36% (n = 8). The susceptibility test revealed that 75.44% (n = 559) isolates were susceptible and 24.56% (n = 182) were resistant to one or more drugs tested. Major resistance was exhibited to flucytosine by C. tropicalis 77.46% (n = 55) compared to C. albicans 11.27% (n = 8). Apart from C. albicans, NAC-C. tropicalis, C. glabrata and Candida krusei showed resistance to echinocandins, and Candida haemulonii to amphotericin-B.ConclusionThe knowledge of the incidence, resistance and emergence of different species might guide clinicians to select an appropriate antifungal therapy and plan effective strategies to control invasive and systemic Candida infections.

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Section: Discussionmentioning

confidence: 60%

Section: Introductionmentioning

confidence: 99%

Retrospective analysis on distribution and antifungal susceptibility profile of Candida in clinical samples: a study from Southern India

Shivaswamy

Sumana

2023

Front. Public Health

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“…Several studies have reported that even with the use of highly active antiretroviral therapy (HAART) in HIV-infected patients, opportunistic infections represent a serious health problem [ 3 ]. Approximately 60-80% of HIV-infected patients develop candidiasis [ 5 ]. In developing countries, the mortality rate due to HIV infection leading to AIDS was four to 15 times higher than that of developing countries, although systematic data are lacking [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Antifungal Resistance Profile, Biofilm Formation, and Virulence Factor Production in Candida krusei Isolates From HIV-Infected Patients in Cameroon

Kountchou,

Noubom,

Ndezo Bisso

et al. 2023

Cureus

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Background Fungal infections mainly caused by Candida krusei are increasing rapidly and represent a serious public health problem in human immunodeficiency virus (HIV)-infected patients. This study aimed to investigate the antifungal susceptibility profile and virulence factors in C. krusei isolated from HIV-infected patients. Methodology Isolates were identified by biochemical and molecular methods. The antifungal resistance profile was established based on the antifungal susceptibility test performed using the Sensititre YeastOne™ (Thermo Fisher Scientific, Waltham, MA) microdilution technique. The production of phospholipase and proteinase was detected by standard methods. Biofilm formation was performed by the microtiter plate method. Results A total of 73 isolates of C. krusei were recovered from stool, oral swabs, vaginal swabs, and urine samples. The highest number of C. krusei isolates (49, 67.05%)was recovered from stool samples. A total of 32.56% of the C. krusei isolates were multidrug-resistant (MDR). The patients living with HIV and not receiving antiretroviral treatment displayed the highest number of C. krusei isolates (29, 39.76%), whereas the patients living with HIV on antiretroviral therapy exhibited the lowest number of C. krusei isolates (2, 2.72%). All isolates were categorized as strong biofilm producers. Among the production of hydrolytic enzymes, 25 (58.13%) and 24 (55.81%) of C. krusei isolates were classified as strong phospholipase and proteinase producers, respectively. Conclusion The C. krusei isolates obtained in this study were MDR and strongly expressed biofilm formation and both phospholipase and proteinase hydrolytic enzymes. The results show how pathogenic C. krusei is in the HIV-infected population and will contribute toward the management of C. krusei- related infections, which may help improve the life quality of people living with HIV.

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Molecular identification and antifungal susceptibility pattern of Candida species isolated from HIV infected Patients with candisiasis

Paul¹,

Kannan²

2019

CMM

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Background and Purpose: Opportunistic fungal infections have been on a growingtrend since the last two decades. Among the opportunistic fungal agents, Candidaspecies, Cryptococcus neoformans, and Aspergillus fumigatus account for most of thelife-threatening infections in immunocompromised individuals. Regarding this, thepresent study aimed to investigate the molecular identification and antifungalsusceptibility pattern of Candida species isolated from HIV-infected patients.Materials and Methods: This study was conducted on 80 clinical samples collectedfrom HIV-infected patients with suspected candidiasis referring to Tagore MedicalCollege and Hospital, Rathinamangalam and Government Hospital of ThoracicMedicine, in Chennai, India, for 18 months (i.e., May 2016-December 2017). Phenotypicand molecular identification was accomplished using internal transcribed spacer region 1(ITS1) and ITS4 primers. The antifungal susceptibility pattern of the isolates against fourantifungal agents was also determined by both disk diffusion and broth dilution methods.Results: In the present study, the prevalence of candidiasis was obtained as 75% (n=60).Candida tropicalis was the predominant identified species. All the emerging species(i.e., Kodamaea ohmeri, Hanseniaspora opuntiae, and C. orthopsilosis) were identifiedthrough molecular identification since the phenotypic identification was inconclusive. Interms of the susceptibility pattern, 63.3% and 18.3% of the isolates were resistant tofluconazole and voriconazole, respectively. Candida albicans was also found to beresistant to amphotericin B.Conclusion: Molecular assay led to the identification of K. ohmeri, H. opuntiae, and C.orthopsilosis, which were multidrug-resistant. This study highlighted the need for theprompt and timely identification of clinical yeast isolates given the emergence of manyrare species and their capability of causing life-threatening infections and outbreaks. Inthe laboratories where molecular diagnostic methods are not available, alternativeservices of reference laboratories can be utilized as cost-effective measures. With regardto the growing prevalence of antifungal drug resistance, antifungal susceptibility testingshould be made mandatory for effective patient management.

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A study of candidiasis in HIV reactive patients in a tertiary care hospital, Mysore - South India

Cited by 4 publications

References 2 publications

Retrospective analysis on distribution and antifungal susceptibility profile of Candida in clinical samples: a study from Southern India

Retrospective analysis on distribution and antifungal susceptibility profile of Candida in clinical samples: a study from Southern India

Antifungal Resistance Profile, Biofilm Formation, and Virulence Factor Production in Candida krusei Isolates From HIV-Infected Patients in Cameroon

Molecular identification and antifungal susceptibility pattern of Candida species isolated from HIV infected Patients with candisiasis

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