Emerging Candida Species Isolated From Tertiary Care Hospital, Lahore: Species Distribution and Susceptibility Profile

Emerging Candida Species Isolated From Tertiary Care Hospital, Lahore

Abstract

Objective: In the last five years, invasive Candida infections have become more prevalent. Along with Candida albicans, non-albicans candida (NAC), infections are also increasing. The study aimed to identify the emerging candida species from clinical samples and to estimate their susceptibility profile.

Materials and Methods: All Candida suspected samples were collected from Tertiary Care Hospital, Lahore. Samples were processed on sabouraud and blood agar. Wet prep was done for confirmation of Candida. Germ tube testing was done to differentiate C. albicans from NAC. Specie identification and antifungal susceptibility were performed by VITEK 2.0 compact system. 18sr RNA Sequencing was performed for unidentified Candida species.

Results: Out of 86 confirmed Candida samples, 41 were identified as C. albicans by germ tube testing, and 45 were NAC. VITEK 2.0 results indicated that C. tropicalis was isolated from a maximum of 33.3% of samples among NAC. There were 5 cases of candida co-existing with bacterial pathogens, while more than half (58%) were obtained from the Intensive Care Unit (ICU) patients. The antifungal susceptibility pattern of NAC species indicated that most NAC was susceptible. Out of 15 isolates of Candida tropicalis, 11(73.0%) were susceptible to fluconazole, and susceptibility against the other antifungals was 100%. All of the isolates of C. glabrata were 100 % susceptible to micafungin, amphotericin B, and flucytosine. All C. krusei, and C. guilliermondii isolates were susceptible to all the tested antifungals except fluconazole, and amphotericin B, respectively. C. ciferrii showed 100% susceptibility to all antifungals.

Conclusion: All ten unidentified isolates showed 100% susceptibility to all the drugs except fluconazole. This study has shown increased NAC and high susceptibility to antifungals.