Original Articles
Virulence and antifungal susceptibility pattern of Candida isolates in ICU patients: a prospective observational study from kumaon region, Uttarakhand, India | |
Amit Gupta, Sneha Mittal, Vaibhav Kumar, Ravi Saini | |
Background: Candidiasis is emerging as a significant health problem in hospitalized patients especially in ICU setup. There is relative rise in the proportion of Non-albicanscandida (NAC) and antifungal resistance. Virulence factors of fungi also contribute to pathogenesis of disease process and its resistance pattern. Aim and Objective: Virulence and antifungal susceptibility pattern of Candida isolates in ICU patientsof Dr. Susheela Tiwari Government Hospital,Haldwani, Uttarakhand. Materials and Methods:A prospective observational study was conducted for two years from Nov 2015 to Oct 2017 and 2323 samples were collected from suspected cases of Candida infection, admitted in critical care units of Dr. Susheela Tiwari Government Hospital, Haldwani. Identification of Candida species was done by standard laboratory approaches. Virulence factors like Biofilm and Coagulase production were assessed by tube method whereas Haemolysin activitywas assessed on blood enriched SDA agar. Antifungal susceptibility testing was done by Disc diffusion method (M 44-A).Results:Out of 2323 clinical specimens, 104 (4.47%) were positive for Candida species, of which34(32.69%) were C. albicans, while 70(67.30%) were Non-albicansCandida (NAC).Most frequently isolated Non-albicans Candida was C. tropicalis (41.34%). Biofilm production was found to occur more frequently among Non-albicans Candida (72.0%). Coagulase and haemolysin production was found to be more in C. albicans than NAC. Antifungal susceptibility testing showed resistance to fluconazole was highest in both C.albicans and NAC species. The drug resistance to itraconazole was more in NAC as compared to C. albicans and this difference in the resistance pattern was statistically significant. (p<0.005)Conclusion: Fungi have emerged as an important public health problem. Identification and antifungal susceptibility testing of Candida isolates from ICU patients will help in building a data center of the prevalent Candida species and will go a long way in the management of patients suffering from candidiasis. |
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