Prevalence and Antifungal Susceptibility of Candida Species at a Tertiary Care Hospital in North India

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Saher Khan, Mastan Singh, Vineeta Khare, M. M. Abid Ali khan, Prashant Gupta5


Background:The introduction of Candida species other than Candida albicans as the primary agents has caused a recent shift in the epidemiology of candidiasis, which is extremely concerning on a global scale.Some species of Candida are naturally resistant to azoles. For directing therapy, in vitro susceptibility testing is crucial.

 Aim: This study was conducted to determine the prevalence of Candida spp. and evaluate its susceptibility profile against antifungal agents at a tertiary care center in North India.

Methods: A total of 140 confirmed cases of Candida infection were enrolled. Demographic and epidemiological details like gender and specimen type were noted. Species identification was done by phenotypic methods and Antifungal susceptibility testing was done by E test.

Results: Majority of patients were females (n=87; 62.1%). Urine (n=65; 46.4%), was the most common specimen followed by sputum (n=30; 21.4%) %), blood (n=12; 8.5%) body fluids (n=12; 8.5%) oral swab (n=10; 7.14%), high vaginal swab (n=8; 5.7%) and nail (n=5; 3.5%) respectively) C. tropicalis (n=48 , 34.3%) was the most common species followed by C. albicans (n=35; 25%) C. glabrata (n=21; 15%), C. krusei (n=14; 10%), C. parasilopsis (n=12; 8.5%), C. guilliermondii (n=6; 4.2%) and C. rugosa (n=4; 2.8%) respectively. Regarding antifungal sensitivity Caspofungin and Amphotericin B were found to be most sensitive (100%) against all the species. Fluconazole was the most resistant antifungal agent followed by Itraconazole. Urine was the major source for Candida infection in women suggesting their high susceptibility to candida infection.

Conclusion: Our study highlights the   predominance of NAC species. Caspofungin and Amphotericin B were the most sensitive antifungal agents against all candida species whereas, Fluconazole was least effective. Species Identification and antifungal susceptibility should be done to help the treatment process of Candidal infection.

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