Changing trends of candidemia: A study from western Uttar Pradesh

Background: Candidemia is one of the common health care associated Blood Stream Infections (BSI). Frequency of isolation of various Candida species causing candidemia and their antifungal drug resistance trends in a health care setting can help in timely institution of appropriate empirical antifungal treatment. Aim and Objectives: To observe the species distribution of various Candida species isolated from suspected cases of BSI and their antifungal susceptibility pattern in a tertiary care hospital from western Uttar Pradesh. This study was conducted to speciate Candida isolates isolated from blood culture samples and their antifungal susceptibility testing. Material and Methods: This study was conducted in the Department of Microbiology, Subharti Medical College and associated Chhatrapati Shivaji Subharti Hospital, Meerut for a period of one year. Blood culture was done by BacT/Alert automated blood culture system from BioMerieux, France. Candida isolates recovered from blood culture were further processed for speciation using conventional morphological and biochemical characteristics and antifungal susceptibility testing by Kirby Bauer disk diffusion method. Results: Out of total 70 Candida isolates isolated during the study period C. tropicalis was the predominant isolate accounting for 34.28% followed by C. parapsilosis. The occurrence of candidemia was higher in Intensive Care Units (ICUs) patients (70.83%). Antifungal drug voriconazole was found to be sensitive against all the Candida isolates. Conclusion: Mycological shift towards the isolation of NAC species indicates a changing trend and changing antifungal drug resistance profile accordingly have to be considered before initiation of empirical antifungal treatment.