Prevalence of non-albicans candidemia in a tertiary care hospital in Northeast India

Sabhapandit, Debahuti; Lyngdoh, Wihiwot Valarie; Bora, Ishani; Prasad, Abhijit; Debnath, Koushik; Elantamilan, D.

doi:10.5455/ijmsph.2017.0823622092017

Cited by 5 publications

(5 citation statements)

References 19 publications

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“…In our study, although NAC isolates were more resistant to antifungals than was C. albicans, the difference was statistically significant only for amphotericin B (P = .03). Similar findings have been reported in another study from northeastern India by Sabhapandit D et al 23 Resistance to fluconazole has been observed in 38% of isolates, with NACs being more resistant than C. albicans (36% vs 2%). This finding is of concern because alternative drugs like echinocandins or amphotericin B are more expensive.…”

Section: Discussionsupporting

confidence: 90%

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A complete clinico-epidemiological and microbiological profile of candidemia cases in a tertiary-care hospital in Western India

Rajni

Chaudhary

Garg

et al. 2022

ASHE

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Objective: To identify different Candida spp along with antifungal susceptibility pattern and risk factors associated with candidemia. Design, setting, and patients: This retrospective observational study was conducted in a tertiary-care academic hospital in Jaipur, Western India, for 3 years (July 2017–June 2020). Methods: Blood cultures were performed according to standard microbiological methods, and only 1 isolate per patient was included in the study. Isolates of Candida spp were identified using a VITEK-2 automated system and matrix-assisted laser desorption ionization-time of flight mass spectrometry. Antifungal susceptibility tests were performed using the broth microdilution assay according to the Clinical and Laboratory Standards Institute guidelines. Results: Of 3,443 blood cultures received from suspected sepsis cases, candidemia was identified in 95 (2.8%). In addition to Candida tropicalis (n = 36; 38%) and Candida parapsilosis (n = 17; 18%), 10 isolates of Candida auris comprised the fourth most common cause of candidemia. Presence of central venous catheter and diabetes were statistically significant risk factors for development of candidemia by NAC. Resistance to fluconazole was 36%, resistance to voriconazole was 20%, resistance to 5-flucytosine was 4%, and resistance to amphotericin-B was 7%. C. auris isolates were more resistant than other NAC spp. We detected no resistance among the echinocandins. Conclusions: The emergence of highly resistant isolates like C. auris emphasizes the need for constant monitoring of candidemia cases for species identification and routine antifungal susceptibility so that appropriate measures can be taken to reduce the related morbidity and mortality.

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Section: Discussionsupporting

confidence: 90%

“…Similar rates of resistance have been reported in other contemporary studies as well. 23,26 Resistance to amphotericin B was significantly high in NAC isolates in our study.…”

Section: Discussionmentioning

confidence: 56%

A complete clinico-epidemiological and microbiological profile of candidemia cases in a tertiary-care hospital in Western India

Rajni

Chaudhary

Garg

et al. 2022

ASHE

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“…In concordance with other studies across the country, we observed an overall higher invitro resistance in NAC isolates compared to C. albicans (7,17,18). Azoles including fluconazole showed 100% susceptibility against C. albicans thus implying it can be used as drug of choice in our ICU settings.…”

Section: Discussionsupporting

confidence: 90%

Risk Factors for Candidemia in Intensive Care Unit: A Matched Case Control Study from North-Western India

Rajni

Jain

Gupta

et al. 2022

Acta Med. (Hradec Kralove, Czech Repub.)

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Candidemia is one of the significant causes of mortality amongst critically ill patients in Intensive Care Units (ICUs). This study aimed to assess the incidence, risk factors and antifungal susceptibility pattern in candidemia cases admitted in ICU in a tertiary care hospital in Jaipur, Rajasthan from June 2021 to November 2021. Candida species isolated from blood culture of clinically suspected patients of sepsis were defined as candidemia cases. Blood culture and antifungal susceptibility testing were performed as per standard laboratory protocol. Analyses of risk factors was done between candidemia cases and matched controls in a ratio of 1 : 3. Forty-six candidemic cases and 150 matched controls were included in the study. C. tropicalis was the most prevalent species (22/46; 48%) followed by C. auris (8/46; 17%) and C. albicans (7/46; 15%). Candida species showed good sensitivity to echinocandins (97%) followed by amphotericin B (87%) and voriconazole (80%). In multivariate analysis, longer stay in ICU, presence of an indwelling device, use of immunosuppressive drugs and positive SARS-CoV-2 infection were associated with increased risk of candidemia. The constant evaluation of risk factors is required as prediction of risks associated with candidemia may help to guide targeted preventive measures with reduced morbidity and mortality.

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“…Regarding NAC sensitivity to fluconazole, similar findings were published in a study from India 27 . The increased resistance to fluconazole is of serious concern as it is the most used azole for superficial and deep candidiasis 28 .…”

Section: Discussionsupporting

confidence: 85%

Speciation and Antifungal Susceptibility of Clinical Non-albicans Candida isolated from Patients in a Tertiary Care Centre in Egypt

Dahroug,

Salem,

Tarek

et al. 2023

Egyptian Journal of Medical Microbiology

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Background: There has been a significant rise in morbidity and mortality due to infections caused by Candida spp. with an upsurge in the incidence of non-albicans Candida (NAC), where the clinical outcome is affected by their decreased susceptibility to azoles. Accurate identification is an important step that leads to selecting a suitable antifungal agent. Objectives: This study aimed to identify the main NAC clinical spp. in the hospital setting and to determine the antifungal susceptibility. Methodology: 133 isolates of Candida were identified by culture on Sabouraud Dextrose Agar, Gram stain, and germ tube test. Isolates were then subcultured on HiCrome chromogenic agar medium, and identification was confirmed using Vitek 2 automated compact system. NAC isolates antifungal susceptibility was detected using disk diffusion method and Vitek 2 compact system. Results: The majority of the Candida isolates (75%) were identified as NAC spp. with C. glabrata predominance (96%). HiCrome showed a sensitivity of 97% compared to Vitek 2 system. Disk diffusion showed high sensitivity when tested with amphotericin B, fluconazole, voriconazole and caspofungin of 100%, 95.2%, 100%, and 92.86% respectively compared to Vitek 2. Conclusion: This study confirms the substantial shift in Candida spp. from albicans to NAC. HiCrome chromogenic agar medium could be used as a rapid method for identification of the common NAC spp. Disk diffusion represents a reliable alternative method for routine antifungal susceptibly testing in the absence of automated systems.

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Prevalence of non-albicans candidemia in a tertiary care hospital in Northeast India

Cited by 5 publications

References 19 publications

A complete clinico-epidemiological and microbiological profile of candidemia cases in a tertiary-care hospital in Western India

A complete clinico-epidemiological and microbiological profile of candidemia cases in a tertiary-care hospital in Western India

Risk Factors for Candidemia in Intensive Care Unit: A Matched Case Control Study from North-Western India

Speciation and Antifungal Susceptibility of Clinical Non-albicans Candida isolated from Patients in a Tertiary Care Centre in Egypt

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