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CORRESPONDENCE
Year : 2006  |  Volume : 24  |  Issue : 1  |  Page : 80-81
 

Antibiotic susceptibility of Candida isolates in a tertiary care hospital in Southern India.


Department of Laboratory Medicine, Sagar Apollo Hospital, Bangalore - 560 064, Karnataka, India

Correspondence Address:
J Kenneth
Department of Laboratory Medicine, Sagar Apollo Hospital, Bangalore - 560 064, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0255-0857.19910

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How to cite this article:
Srinivasan L, Kenneth J. Antibiotic susceptibility of Candida isolates in a tertiary care hospital in Southern India. Indian J Med Microbiol 2006;24:80-1

How to cite this URL:
Srinivasan L, Kenneth J. Antibiotic susceptibility of Candida isolates in a tertiary care hospital in Southern India. Indian J Med Microbiol [serial online] 2006 [cited 2019 Dec 5];24:80-1. Available from: http://www.ijmm.org/text.asp?2006/24/1/80/19910


Dear Editor,

Systemic infections due to yeasts and resistance to antifungals is on the rise in Indian hospitals.[1] Candida albicans accounts for 40-60% of yeasts isolated in developed countries[2] whereas Indian reports show an increased predominance of non C. albicans isolates. [1] Increasing resistance to azoles and amphotericin B has been reported both from India and other countries.[1],[2] Given the paucity of data from southern India on the profile of yeast isolates and prevailing patterns of susceptibility to antifungals we speciated 77 yeasts obtained from culture of clinical specimens [Respiratory 22 (27.8%), blood 22 (25.3%), vaginal 12 (15.2%), urine 13 (16.5%) and others 10 (12.7%)] and estimated susceptibility to antifungal drugs. The study period was from September 2004 to March 2005. Isolates of Candida were identified by Gram stain of colony morphotypes suggestive of yeasts and were presumptively reported as C. albicans or Candida spp . based on the positive or negative germ tube test. Species level identification and antifungal susceptibility were done using the API ID 32C for identification and ATB Fungus 2 (bioMerieux, France).[3] Manufacturers' instructions were strictly followed and adequate quality control measures were undertaken to ensure sterility and efficacy of media and reagents used.

The distribution of Candida spp. and their susceptibility is portrayed in the [Table - 1]. The common isolates were C. albicans 36 (47%), Candida tropicalis 18 (23%) and Candida pelliculosa 5 (6%). These three species accounted for 76% of Candida isolates. C. pelliculosa was isolated only from blood cultures of newborn in the neonatal ICU.

Germ tube test was positive in 89% of isolates speciated as C. albicans and 5% of C. tropicalis. The loss of susceptibility of C. albicans to azoles (fluconazole -30% and itraconazole 75%) is of concern although amphotericin B and flucytosine continue to show good efficacy. It is necessary to start presumptive therapy with either of these two antifungals when C. albicans is reported. Of the other Candida species only C. pelliculosa showed 100% susceptibility to the azoles. Flucytosine displays no efficacy against C. pelliculosa , C. krusei and C. parapsilosis. With multiple antifungals and varying susceptibility patterns of Candida it has now become necessary to perform antifungal susceptibility testing real-time and make reports available to the clinician for effective therapeutic outcome.

 
 ~ References Top

1.Chakrabarti A, Mohan B, Shrivastava SK, Marak RS, Ghosh A, Ray P. Change in distribution and antifungal susceptibility of Candida species isolated from candidaemia cases in a tertiary care centre during 1996-2000. Indian J Med Res 2002; 116 :5-12.  Back to cited text no. 1  [PUBMED]  [FULLTEXT]
2.Pfaller MA, Diekema DJ, Jones RN, Messer SA, Hollis RJ. Trends in antifungal susceptibility of Candida spp. isolated from pediatric and adult patients with bloodstream infections: SENTRY Antimicrobial Surveillance Program, 1997 to 2000. J Clin Microbiol 2002;40:852-6.   Back to cited text no. 2    
3.Buchaille L, Freydiere AM, Guinet R, Gille Y. Evaluation of six commercial systems for identification of medically important yeasts. Eur J Clin Microbiol Infect Dis 1998; 17: 479-88.  Back to cited text no. 3  [PUBMED]  [FULLTEXT]


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[Table - 1]

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