Monitoring the Spectrum of Candidemia and its Anti-fungal Resistance in A Tertiary Care Centre – An Emerging Global Alarm

Abstract

Candidemia is caused by healthcare-associated bloodstream infections ranking as a fifth cause especially in the United States as well as in European countries among intensive care units (ICUs). Despite ongoing advances in diagnostics and medical interventions, it remains associated with high mortality rates, along with the prolonged duration of hospitalization and elevated health care costs. The aim of the study is to characterize Candida species and to investigate the antifungal resistance pattern from blood samples in a Tertiary Care centre. 53 known Candida isolates from blood samples of various wards and ICUs were collected. All isolates are processed and speciated by the conventional identification method demonstrating its various virulence factors phenotypically and AFST patterns were studied. In the present study, among 53 Candida isolates, 25 (47.16%) C. tropicalis is a predominant pathogen followed by 11 (20.75%) C. parapsilosis, 9 (16.98%) C. albicans, 4 (7.54%) C. glabrata and 4 (7.54%) C. krusei. Phospholipase activity was observed in 30 (56.60%) isolates, 36 (67.92%) showed hemolysin production. AFST showed 15 (28.30%) isolates being resistant to Fluconazole and 2 (3.77%) showed resistance to Amphotericin B. The prevalence of candidemia was high, the fatality rate was alarming and non-albicans Candida species were predominant and fluconazole was the least effective drug owing to the high level of resistance.

Keywords

• candidemia
• intensive care units
• candida species
• anti-fungal susceptibility test