Antifungal susceptibility and speciation of Candida isolated from blood at a tertiary care centre

Abstract

There has been a rise in the incidence and prevalence of fungal infections worldwide, especially by Candida spp. leading to significant morbidity and mortality. Early recognition of Candida bloodstream infection has been associated with improved outcome in patient care. Hence, the present study was carried out to determine the distribution of the Candida species that causes candidemia as well as its antifungal susceptibility pattern in the hospital. A total of 8,087 blood cultures received from various clinical departments of a tertiary care centre were processed via the Automated blood culture system BACTEC FX40 or manually as per standard protocol in the Department of Microbiology from January to December 2022. Isolated Candida spp. were identified using biochemical tests and CHROM agar. Antifungal susceptibility was performed and interpreted as per Clinical and Laboratory Standards Institute guidelines. A total of 2,010 blood cultures showed a positive culture growth of microorganisms, out of which, Candida spp. was isolated in 123 blood cultures (6.11%). The Neonatal Intensive Care Unit accounted for the isolation of 78.8% of Candida spp. C. krusei was found to be the most common isolate 36.5% followed by C. albicans (21.2%), C. glabrata (19.5%), C. parapsilosis (13.8%) and C. tropicalis (9%). Voriconazole was found to be the most effective antifungal agent, with 81.3% of Candida spp. showing susceptibility to it, and was found to be the most effective antifungal agent. Non-albicans Candida spp., C. krusei was found to be the predominant isolate in the present study. The neonatal age group was the most commonly affected age group in candidemia. It is advisable to monitor the changing trend of Candida species in particular, geographical area to get an idea about prevalent species and their antifungal susceptibility pattern for choosing empirical therapy and better patient management