A study of Candida albicans and non-albicans Candida species isolated from various clinical samples and their antifungal susceptibility pattern

Background: Candida species are the most common cause of fungal infections worldwide. Candida albicans has been the most common causative agent until recent past but frequency of non-albicans Candida (NAC) species is on the rise. This changing epidemiology and increase in resistance to antifungal agents makes it important to identify Candida up to the species level and know its antifungal susceptibility pattern. Aim: To provide data on Candida species prevalence and to highlight the need of speciation of Candida and its antifungal susceptibility testing. Material and methods: For blood cultures, BacT/ALERT blood culture automated system (BioMérieux) was used. Candida was identified initially by direct microscopic examination of samples received and culture was done on SDA with antibiotic. Differentiation of Candida albicans and NAC species was done by germ tube test and final identification and antifungal susceptibility testing were done using Vitek 2 compact. Result: The prevalence of Candida infection in this study is 1.58%. Out of total 100 Candida isolates, 25% were C.albicans and 75% were NAC. Among 75 non-albicans Candida spp.; C.tropicalis (46) forms the major isolate. Other NAC spp. included C.hemulonii (9), C.glabrata (6) & others (14). C.albicans is found to be more susceptible to fluconazole as compared to NAC spp. In this study NAC species showed comparatively reduced susceptibility to fluconazole and amphotericin B. Conclusion: There is a significant epidemiological shift in candidiasis cases due to NAC species. Based on the present results and trends, it becomes essential to routinely identify Candida isolates up to species level, and detect evolving resistant strains by antifungal susceptibility testing wherever feasible.