Species distribution and antifungal susceptibility pattern of Candida causing oral candidiasis among hospitalized patients

Abstract

Background: Oral candidiasis is increasingly seen among hospitalized patients and is usually treated empirically. It can be the marker of systemic infection. Antifingal resistance is one of the emerging problems in candidiasis. Aim and Objectives: To study the distribution pattern of various Candida species among hospitalised patients with oral candidiasis, to detect the antifungal resistance among Candida and to assess the possible risk factors associated with those patients. Methods: Out of 300 patients screened, oral thrush material was collected from 36 patients having oral candidiasis. Candida spp. were isolated and identified. Antifungal susceptibility test was performed by disk diffusion method. Results: Candida albicans was the most frequently isolated species (64%). Highest resistance was seen with ketoconazole (18%). Except one C. tropicalis, all the isolates were sensitive to amphotericin B. All the patients were on broad spectrum antibiotic treatment. Diabetes mellitus was seen in 50 % of the patients. Other predisposing factors include tuberculosis, COPD, cancer and steroid treatment. Conclusion: Eventhough there is progressive shift from a predominance of C. albicans to non-albicans Candida species in candidiasis, C. albicans remains as the most important pathogen in oral candidiasis. Since azole resistance is increasing, accurate identification of Candida spp. and antifungal susceptibility testing is crucial for patient management and for facilitating hospital control measures.

Keywords

• Antifungal susceptibility
• azole
• Candida
• disk diffusion
• oral candidiasis