Characterization and susceptibility of non-albicans Candida isolated from various clinical specimens in Lebanese hospitals

Abstract

BackgroundInvasive fungal infections have presented a challenge in treatment. In the past, it was known that the frontrunner in such infections is Candida albicans with little emphasis placed on non-albicans Candida species (NAC). Studies worldwide have shown a rise in fungal infections attributed to non-albicans Candida species. The aim of this study is to describe the epidemiology of NAC infections along with an overview of resistance in Lebanese hospitals.MethodsThis is a two-year observational multi-central descriptive study. Between September 2016 and May of 2018, a total of 1000 isolates were collected from 10 different hospitals distributed all over the country. For the culture, Sabouraud Dextrose Agar was used. Antifungal Susceptibility was evaluated by determining the Minimum Inhibitory Concentration (MIC) in broth (microdilution) of the different antifungal treatments.ResultsOut of the 1000 collected isolates, Candida glabrata, being the most isolated species (40.8%), followed by Candida tropicalis: 231(23.1%), Candida parapsilosis: 103(10.3%), and other NAC species at lower percentage. Most of these isolates (88.67%) were susceptible to posaconazole, 98.22% were susceptible to micafungin, and 10% were susceptible to caspofungin.ConclusionThe change of etiology of fungal infections involving a significant increase in NAC cases is alarming due to the different antifungal susceptibility patterns and the lack of local guidelines to guide the treatment. In this context, proper identification of such organisms is of utmost importance. The data presented here can help in establishing guidelines for the treatment of candida infections to decrease morbidity and mortality. Future surveillance data are needed.

Prevalence of Candida Species Isolated from Immuno-Compromised Patients

“…Among the total study population (n=44), Candida tropicalis was found to be the dominant isolate (41%), followed by Candida albicans (23%). Similar Candida non-albicans trends have been isolated and observed in various studies [11][12][16][17][18][19][20], whereas other research shows a pervasiveness of Candida glabrata and Candida albicans [21][22][23][24]. Phospholipase occurrence and biofilm emergence have been identified as important virulence determinants in Candida tropicalis, both of which contribute to pathogenic organisms in candidemia patient populations [20,25].…”

Biofilm Formation and Antifungal Susceptibility Profile of Candida Species Responsible for Vulvovaginal Candidiasis in Pregnant and Non-Pregnant Women visiting a Tertiary Care Hospital in Southern India

“…[36][37][38] Various studies performed in recent years on the antifungal resistance in NCAC have proved the same. 39 The present study reported 41.76% prevalence of C. albicans. 24.27% of C. glabrata, 20.88% of C. krusei and 8.79% of C. tropicalis and 4.39% of C. parapsilosis were isolated among NCAC.…”

Phenotypic and Genotypic Characterization of Candida parapsilosis complex isolates from a Lebanese Hospital

“…One interesting but unexpected aspect of our study is the rate of isolate-misidentification 50. All our isolates were labeled by our tertiary care center as C. parapsilosis [ 11 ]. However, based on our whole genome sequencing data a significant percentage of our isolates- 3 out of 9- were misidentified.…”

“…Nine C. parapsilosis hospital isolates were obtained from the Lebanese American University Medical Center, Rizk Hospital, Beirut in Lebanon. Species identification and broth microdilution antifungal susceptibility testing ( Table 1 ) was performed by Husni et al [ 11 ]. Four out of nine isolates were resistant to fluconazole, designated as isolates R1, R2, R3 and R4 and the five others designated as isolates S1, Ca, Co, S2 and Cm were sensitive to fluconazole.…”