ISSN: 2471-9315
Kripa Ghimire, K Rajeshwar Reddy, Shristi Raut
Introduction: The upward trends of fungal infections in the recent times contribute to high rates of morbidity and mortality. Candida species are commensal yeasts of skin and part of gut microbiota. The altered host immune system together with abnormal colonization and invasive medical technologies contribute to opportunistic infections. Candidiasis may be superficial or deep-seated. Increase in antifungal resistance recently has rendered treatment difficult due to restricted number of antifungal drugs.
Methods: This is a descriptive cross-sectional study done for a period of 18 months at a tertiary care center. Ethical clearance was obtained from institutional review committee with a reference number (UCMS/IRC/036/18). Two hundred isolates of Candida species were identified from various clinical samples by using phenotypic tests such as chrom agar, sugar fermentation test, sugar assimilation test and germ tube test. Antifungal susceptibility test was performed for five drugs namely ketoconazole (10 μg), fluconazole (10 μg), itraconazole (10 μg), nystatin (100 μg) and amphotericin-B (20 μg). All the statistical evaluation was done by using SPSS version 20.0 software (IBM Corp., Armonk, NY).
Results: Among 200 isolates of Candida, the most frequently isolated species was C.albicans which was seen in 69% of total isolates followed by C. tropicalis, C. krusei, and C. dubliniensis. Maximum Candida isolates were from urine sample (41.5%) followed by sputum (22.5%). Amphotericin B was found to be the most sensitive drug with a sensitivity of 97.1% whereas ketoconazole was the least sensitive drug with a sensitivity of 40.5% among the isolates.
Conclusion: C. albicans were the major isolates in this study, however, there is an increased incidence of non-albicans Candida species. Antifungal susceptibility test revealed increased resistance to different antifungal drugs among Candida species. This may conclude that delay in diagnosis and increased resistance may lead to serious complications and depicts the need of new therapeutic options.