PREVALENCE AND ANTIFUNGAL SUSCEPTIBILITY OF CANDIDA SPECIES IN BLOODSTREAM INFECTIONS AMONG PEDIATRIC PATIENTS IN A TERTIARY CARE HOSPITAL
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Keywords
Candida albicans; Non-albicans Candida; Candidemia; Antifungals; Candidemia; Resistance; VITEK
Abstract
Introduction: Candidemia, a severe and potentially life-threatening bloodstream infection caused by Candida species, remains a significant concern in pediatric populations, especially in developing countries such as India. The increasing prevalence of non-albicans Candida (NAC) species, which often exhibit reduced susceptibility to commonly used antifungal agents, has further complicated clinical management and therapeutic outcomes.
Aim: The present study aimed to evaluate the prevalence of Candida species in bloodstream infections among pediatric patients and to characterize their antifungal resistance patterns.
Material and methods: Blood samples from patients with suspected candidemia were collected in automated blood culture bottles. Identification of Candida species was performed using standard microbiological techniques, including the VITEK 2 Compact system. Antifungal susceptibility was assessed using the AST-YS09 card, which determines the minimum inhibitory concentration (MIC) for six antifungal agents i.e., voriconazole, caspofungin, flucytosine, micafungin, fluconazole, and amphotericin B.
Results: A total of 97 (6.2%) Candida isolates were identified, with Candida albicans (32%) being the most prevalent species, followed by Candida tropicalis (22.6%), Candida parapsilosis (19.5%), Candida pelliculosa (12.3%), Candida glabrata (7.2%), Candida krusei (4.1%), and Candida guilliermondii (2%). Antifungal resistance was notable, with 36% of isolates resistant to flucytosine, 32% to fluconazole, 26% to amphotericin B, 21.6% to voriconazole, 14.4% to micafungin and 12.3% to caspofungin.
Conclusion: Our study highlights a higher incidence of non-albicans Candida species compared to Candida albicans, with a notable resistance to various antifungal agents. These findings underscore the urgent need for antifungal stewardship programs and stringent preventive control measures to mitigate the further spread of antifungal resistance.
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Jagriti Bansal
Tutor, Department of Microbiology, Government Institute of Medical Sciences, Greater Noida
Varun Goel
Associate Professor, Department of Microbiology, Government Institute of Medical Sciences, Greater Noida
Kushal Singh
Tutor, Department of Microbiology, Government Institute of Medical Sciences, Greater Noida
Ajay Kumar Sahni
Professor & Head, Department of Microbiology, Government Institute of Medical Sciences, Greater Noida
Mukhopadhayay S
Associate Professor, Department of Pediatrics, Government Institute of Medical Sciences, Greater Noida
Manish Kumar Singh
Assistant Professor, Department of Microbiology, Shaikh-Ul-Hind Maulana Mahmood Hasan Medical College, Saharanpur