COMPARATIVE STUDY OF PHENOTYPIC AND AUTOMATED METHODS IN IDENTIFICATION AND ANTIFUNGAL SUSCEPTIBILITY OF CANDIDA SPECIES ISOLATED FROM CLINICAL SAMPLES
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Keywords
Abstract
Candida, a fungus which was thought to be a harmless commensal a few decades ago has grown into a problem of enormous medical significance. It causes a plethora of diseases, ranging from superficial mycoses to deep seated invasive candidemia, which carries a mortality rate of above 50% in developing countries.[1]
To successfully treat candida infections and prevent unnecessary deaths,proper identification of candida species along with antifungal susceptibility testing(AST) is of paramount importance. Quickly commencing the correct antifungal treatment can double the chances of survival.[2][3][4]
Unfortunately, these are hardly carried out in resource poor countries, leading to treatment failures and selection of resistance strains[5] while at the same time subjecting the patients to the toxic side effects of inefficient antifungals. Few patients have mixed infection with 2 or more candida species,[6]and giving an empirical drug to which only 1 species is susceptible does not lead to complete cure and there is recurrence of the disease after cessation of the drug. Also the susceptibility of candida species to antifungals vary in different parts of the country[7] and resistance to newer class of drugs like echinocandins is not well known.[8] Lastly, ICMR recently released an advisory warning about the emergence of multi-drug resistant candida auris.[9]In all these cases, identification of species along with AST provides valuable epidemiological data which can pinpoint the source of an outbreak ,quickly identify and treat such vicious species, leading to reduced morbidity and mortality.
References
] Kaur H, Chakrabarti A. Strategies to Reduce Mortality in Adult and Neonatal Candidemia in Developing Countries. J Fungi (Basel). 2017;3(3):41. Published 2017 Jul 19. doi:10.3390/jof3030041 STS reference ID - 2019-02367
[2] Garey K.W., Rege M., Pai M.P., Mingo D.E., Suda K.J., Turpin R.S., Bearden D.T. Time to Initiation of Fluconazole Therapy Impacts Mortality in Patients with Candidemia: A Multi-Institutional Study. Clin. Infect. Dis. 2006;43:25–31. doi: 10.1086/504810
[3] Morrell M., Fraser V.J., Kollef M.H. Delaying the empiric treatment of Candida bloodstream infection until positive blood culture results are obtained: A potential risk factor for hospital mortality. Antimicrob. Agents Chemother. 2005;49:3640–3645. doi: 10.1128/AAC.49.9.3640-3645.2005
[4] Le J., Tran T.T., Bui I., Wang M.K., Vo A., Adler-Shohet F.C. Time to initiation of antifungal therapy for neonatal candidiasis. Antimicrob. Agents Chemother. 2013;57:2550–2555. doi: 10.1128/AAC.02088-12
[5] Dinoop Korol Ponnambath et al., Clinico-mycological and Antifungal Susceptibility Profiles of Candiduria in A Tertiary Care Hospital From Southern India. National Journal of Laboratory Medicine. 2017 Oct, Vol:6(4): MO07-MO12. Doi: 10.7860/NJLM/2017/28472:2254
[6] Jayalakshmi, D.S., RatnaKumari, D.G., & Samson, D. (2015). Isolation , Speciation and Antifungal Susceptibility Testing of Candida from Clinical Specimens at a Tertiary Care Hospital.
[7] Kumar et al, Distribution and susceptibility to various antifungal agents among blood stream Candida isolates from Neonatal intensive care unit . Asian Pac. J. Health Sci., 2018; 5(3):97-102, doi : 10.21276/apjhs.2018.5.3.13
[8] Anjana Gopi, Neetha S. Murthy. “Presumptive Identification of Candida Species by using Chromogenic Agar in Comparison with Yeast Identification Protocols in a Tertiary Care Hospital”. Journal of Evidence based Medicine and Healthcare; Volume 1, Issue 13, December 01, 2014; Page: 1604-1613
[9] Walia K, Chowdhary A, Ohri V C, Chakrabarti A. Multidrug-resistant Candida auris: Need for alert among microbiologists. Indian J Med Microbiol 2017;35:436 , doi: 10.4103/ijmm.IJMM_17_345
[10] Chakrabarti A, Shivaprakash M, Ghosh A. Standard Operating procedures, Mycology Laboratories. Indian Council of Medical Research. 2016:5-47.
[11] Odds FC, Bernaerts R. CHROMagar Candida, a new differential isolation medium for presumptive identification of clinically important Candida species. J Clin Microbiol. 1994;32(8):1923-9.
[12] D.S. ElFeky et al. Species identification and antifungal susceptibility pattern of Candida isolates in cases of vulvovaginal candidiasis . Alexandria Journal of Medicine (2016) 52, 269–277 doi : /10.1016/j.ajme.2015.10.001
[13] Rippon JW , Medical Mycology , Second edition, Candidiasis and the Pathogenic yeasts, 1982, 484- 531
[14] . Pfaller,Clinical Mycology ,Chapter 6 ,Candida ,Pg 201
[15] Topley & Wilson’s Microbiology and Microbial infections , Medical Mycology, 10th edition, 2005, Chapter-30, Candidiasis , Pg :579-620
[16] . Talaro, A. and Talaro, K. (1996) “Foundations in microbiology”. 2nd edition .Wm. C. STS reference ID - 2019-02367 Brown Publisher; USA. page 673- 701
[17] Khatib, R. and Clark, J. A. (1995) "Relevance of culturing Candida species from intravascular catheters." J. Clin. Microbiol. 33(6): 1635-7
[18] Murray, P. R., Baron, E. J., Pfaller, M. A., Tenover, F. C. and Yolken, R.H. (2002) “Manual of clinical microbiology ASM press. Washington D.C.
[19] Odds, F. C. (1988) Candida and candidosis: A review and bibliography. 2nd. Ed., London: Balliere Tindall: 68-92 [20] . Sobel, J. D. (1992) "Pathogenesis and treatment of recurrent vulvovaginal candidiasis." Clin. Infect. Dis. 14 Suppl (1:S1): 48 – 53
[21] Akalm, H., Ener, B., Kahveci, F., Akcaglar, S., Gurcan, S. and Tore, O. (2004) "Persistent of candiduria in ICU catheterized patients is not linked to adherence and proteolytic activities Candida strains." Intens. Care. Med. 30: 972-975
[22] Sobel, J. D. (2002) "Controversies in the diagnosis of candiduria: what is the critical colony count?" Infect. Dis. 4: 81-83
[23] Collier, L., Balows, A. and Sussman, M. (1998) “Topley & Wilson’s Microbiology and microbial infections”.9th Ed, vol 4; Arnold, London, Sydney, Auckland, New Yorke
[24] . el-Ebiary, M., Torres, A., Fabrega, N., Puigdela Bellacasa, J., Gonzalez, J., Ramirez, J., del Bano, D., Hernandez, C. and Jimenez de Anta, T. (1997). "Significance of the isolation of Candida species from respiratory samples in critically ill, non-neutropenic patients. An immediate postmortem histologic study." Am. J. Respir. Crit. Care. Med. 156 (2 Pt 1): 583-90. [25] Gross, N. T, Arias, M. L., Moraga, M., Baddasarow, Y. and Jarstrand, C. (2007) "Species distribution and susceptibility to azoles of vaginal yeasts isolated from prostitutes." Infect. Dis. Obstet. Gynecol. 2007; 2007: 82412.
[26] . Asticcioli, S., Sacco, L., Daturi, R., Matti, C., Nucleo, E., Zara, F. and Pagani, L. (2009) "Trends in frequency and in vitro antifungal susceptibility patterns of Candida isolates from women attending the STD outpatients clinic of a tertiary care hospital in Northern Italy during the years 2002-2007." New. Microbiol. 32(2): 199-204
[27] Mohanty, S., Xess, I., Hasan, F., Kapil, A., Mittal, S. and Tolosa, J. E. (2007) "Prevalence and susceptibility to fluconazole of Candida species causing vulvovaginitis." Indian. J. Med. Res. 126: pp 216 -219
[28] Galle, L. C. and Gianinni, M. J. (2004) "Prevalence and susceptibility of vaginal yeast." J. Bras. Patol. Med. Lab. vol 40 (4): page 229-236
[29] Tulumoglu, S., Kariptas, E. and Erdem, B. (2009) "Identification and antifungal STS reference ID - 2019-02367 susceptibility of Candida isolates from various clinical specimens in Doctor Becchet UZ Hospital." Anatol. J. Clin. Investig. vol 3: page 170 – 173
[30] Baran, J. Jr., Klauber, E., Barczak, J., Riederer, K. and Khatib, R. (2000) "Trends in antifungal susceptibility among Candida sp. urinary isolates from 1994 and 1998." J. Clin. Microbiol. 38(2): 870-1
[31] . Zepelin, M.B-v., Kunz, L., Ruchel, R. and Reichard, U. (2007) "Epidemiology and antifungal susceptibilities of Candida spp to six antifungal agents: results from a surveillance study on fungemia in Germany from July 2004 to August 2005." J.Antimicrob. Chemother. 60(2): 424 – 428
[32] Hamza, O.J., Matee, M.I.N., Moshi, M.T., Simon, E. N.M., Mugusi, F., Mikx, F.H.M., Helderman W.H.P., Rijs, A.J.M., Vanderven A.J.M and Verwij, P. E. (2008). "Species distribution and in vitro antifungal susceptibility of oral yeast isolates from Tanzanian HIV-infected patients with primary and recurrent oropharyngeal candidiasis." BMC. Microbiol. 8: 135
[33] . Bii, C. C., Ouko, T. T., Amukoye, E. and Githinji, L.W. (2002) "Antifungal drug susceptibility of Candida albicans." East. Afr. Med. J. 79(3): 143-5.
[34] . Sachin Chandrakant Deorukhkar, Shahriar Roushan(2018)” Identification of Candida Species: Conventional Methods in the Era of Molecular Diagnosis Ann Microbiol Immunol. 2018; 1(1): 1002
[35] . Mangalkar S M, Sagar K B, Gohel T, Sayare P C “antifungal susceptibility testing in various clinical samples” 2015; 16(2): 440-445
[36] . Vijaya D. et al., Candida Speciation Using Chrom Agar Journal of Clinical and Diagnostic Research. 2011 August, Vol-5(4): 755-757
[37] . L. Sumitra Devi, Megha Maheshwari – Speciation of candida species isolated from clinical specimens using Chromagar and conventional methods ,International Journal of Scientific and Research Publications, Volume 4, Issue 3, March 2014
[38] . Dadhich, et al.: Detection of Candida Species by Hichrom Agar and Their Antimycotic Sensitivity in Hadoti Region International Journal of Scientific Study | July 2016 | Vol 4 | Issue 4
[39]Bharathi “Comparison of chromogenic media with the corn meal agar for speciation of candida” Journal of Pure and Applied Microbiology, ISSN: 2581-690X, Vol: 12, Issue: 3, Page: 1617-1622 (2018)
[40] Pfaller MA, Diekema DJ, Procop GW, Rinaldi MG. Multicenter comparison of the VITEK 2 yeast susceptibility test with the CLSI broth microdilution reference method for testing fluconazole against Candida species. J Clin Microbiol. 2007;45(3):796-802.
[41] Melhem M, Bertoletti A, Lucca H, Silva R, Meneghin F, Szeszs M. Use of the VITEK 2 system to identify and test the antifungal susceptibility of clinically relevant yeast species. Braz J Microbiol. 2013;44(4):1257-66. STS reference ID - 2019-02367
[42] Kaur R, Dhakad MS, Goyal R, Haque A, Mukhopadhyay G. Identification and Antifungal Susceptibility Testing of Candida Species: A Comparison of Vitek-2 System with Conventional and Molecular Methods. J Glob Infect Dis. 2016;8(4):139-146.
[43]Neetu jain et al –Rapid identification of yeast isolates from clinical specimens in critically ill Trauma ICU patients , Journal of Laboratory Physicians / Jan-Jun 2012 / Vol-4 / Issue-1 [44] Giri S, Kindo AJ. Evaluation of antifungalsusceptibility testing in Candida isolates by Candifast and disk-diffusion method. Indian J Pathol M! icrobiol 2014;57:595-7
[45] . Ruchi Goel, Surinder Singh, Amarjit Kaur Gill, Amandeep Kaur, Ivneet Kour. Speciation, characterization and antifungal susceptibility pattern of candida species. International Journal of Contemporary Medical Research 2018;5(5):E1-E4.
[46] Veenu Gupta - SPECIATION AND ANTIFUNGAL SUSCEPTIBILITY PROFILE OF CANDIDURIA CASES AT A TERTIARY CARE HOSPITAL,IJPRBS, 2015; Volume 4(6): 137-144
[47] Tejashree A et al-Speciation and In-vitro antifungal Susceptibility Testing of candida isolates in various clinical samples in a tertiary care hospital in south india , International Journal of Advanced Scientific and Technical Research, Issue 4 volume 5, Sep. – Oct. 2014
[48] Elmer Koneman, Stephen Allen, William Janda, Colour Atlas and Textbook of diagnostic Microbiology, 6th edition 2006
[49] Mine Yucesoy and Serhat Marol,Performance of CHROM agar Candida and BIGGY agar for identification of yeast species, Annuals of Clinical Microbiology and Antimicrobials ; 2;8
[50] Negri et al ,Correlation between E test , Disk Diffusion , and Microdilution methods for antifungal susceptibility testing of Candida species from Infection and Colonisation , Journal of clinical laboratory Analysis,2009,23:324 -330
[51] Gandham NR, Vyawahare CR, Jadhav SV, Misra RN. Candidemia: Speciation and Antifungal susceptibility testing from a Tertiary Care Hospital in Maharashtra, India. Med JDY Patil Univ 2016;9:596- 9.
[52] [52]Neil M. Ampel. Emerging Disease Issues and Fungal Pathogens Associated with HIV infection. Emerging Infectious Diseases 1996; 2:109-116
[53] Nelson M, Wanjiru W, Margaret MW. Prevalence of vaginal candidiasis and determination of the occurrence of Candida species in pregnant women attending the antenatal clinic of Thika District Hospital, Kenya. Open J Med Microbiol. 2013;2013:264–272. STS reference ID - 2019-02367
[54] Anorlu R, Imosemi D, Odunukwe N, Abudu O, Otuonye M. Prevalence of HIV among women with vaginal discharge in a gynecological clinic. J Natl Med Assoc. 2004;96(3):367
[55] . Iman KB, Shorouk KEH, Muhmoud M. Candida infection associated with urinary catheter in critically ill patients. Identification, antifungal susceptibility and risk factors. Res.J. of Med and Med sciences. 2010; 5:79-86
[56] Manikandan C. and Amsath A characterization and susceptibility pattern of Candida species isolate d from urine samples in Pattukkottal,Tamilnadu, India. International journal of pure and applied zoology 2015;3:17-23.
[57] Sagar K, Mangalkar S, Gohel T Isolation of Different Candida Species from Clinical Samples and Comparison between Conventional and Hicrome Technique of Identification International Journal of Science and Research (IJSR) ISSN (Online): 2319-7064.
[58] WadhaAlfouzana,b, , Tahani Al-Enezia , EbteehalAlRoomi. Comparison of the VITEK 2 antifungal susceptibility system with Etest using clinical isolates of Candida speciesVol.34,number 3, page171-174 July –September 2017
[2] Garey K.W., Rege M., Pai M.P., Mingo D.E., Suda K.J., Turpin R.S., Bearden D.T. Time to Initiation of Fluconazole Therapy Impacts Mortality in Patients with Candidemia: A Multi-Institutional Study. Clin. Infect. Dis. 2006;43:25–31. doi: 10.1086/504810
[3] Morrell M., Fraser V.J., Kollef M.H. Delaying the empiric treatment of Candida bloodstream infection until positive blood culture results are obtained: A potential risk factor for hospital mortality. Antimicrob. Agents Chemother. 2005;49:3640–3645. doi: 10.1128/AAC.49.9.3640-3645.2005
[4] Le J., Tran T.T., Bui I., Wang M.K., Vo A., Adler-Shohet F.C. Time to initiation of antifungal therapy for neonatal candidiasis. Antimicrob. Agents Chemother. 2013;57:2550–2555. doi: 10.1128/AAC.02088-12
[5] Dinoop Korol Ponnambath et al., Clinico-mycological and Antifungal Susceptibility Profiles of Candiduria in A Tertiary Care Hospital From Southern India. National Journal of Laboratory Medicine. 2017 Oct, Vol:6(4): MO07-MO12. Doi: 10.7860/NJLM/2017/28472:2254
[6] Jayalakshmi, D.S., RatnaKumari, D.G., & Samson, D. (2015). Isolation , Speciation and Antifungal Susceptibility Testing of Candida from Clinical Specimens at a Tertiary Care Hospital.
[7] Kumar et al, Distribution and susceptibility to various antifungal agents among blood stream Candida isolates from Neonatal intensive care unit . Asian Pac. J. Health Sci., 2018; 5(3):97-102, doi : 10.21276/apjhs.2018.5.3.13
[8] Anjana Gopi, Neetha S. Murthy. “Presumptive Identification of Candida Species by using Chromogenic Agar in Comparison with Yeast Identification Protocols in a Tertiary Care Hospital”. Journal of Evidence based Medicine and Healthcare; Volume 1, Issue 13, December 01, 2014; Page: 1604-1613
[9] Walia K, Chowdhary A, Ohri V C, Chakrabarti A. Multidrug-resistant Candida auris: Need for alert among microbiologists. Indian J Med Microbiol 2017;35:436 , doi: 10.4103/ijmm.IJMM_17_345
[10] Chakrabarti A, Shivaprakash M, Ghosh A. Standard Operating procedures, Mycology Laboratories. Indian Council of Medical Research. 2016:5-47.
[11] Odds FC, Bernaerts R. CHROMagar Candida, a new differential isolation medium for presumptive identification of clinically important Candida species. J Clin Microbiol. 1994;32(8):1923-9.
[12] D.S. ElFeky et al. Species identification and antifungal susceptibility pattern of Candida isolates in cases of vulvovaginal candidiasis . Alexandria Journal of Medicine (2016) 52, 269–277 doi : /10.1016/j.ajme.2015.10.001
[13] Rippon JW , Medical Mycology , Second edition, Candidiasis and the Pathogenic yeasts, 1982, 484- 531
[14] . Pfaller,Clinical Mycology ,Chapter 6 ,Candida ,Pg 201
[15] Topley & Wilson’s Microbiology and Microbial infections , Medical Mycology, 10th edition, 2005, Chapter-30, Candidiasis , Pg :579-620
[16] . Talaro, A. and Talaro, K. (1996) “Foundations in microbiology”. 2nd edition .Wm. C. STS reference ID - 2019-02367 Brown Publisher; USA. page 673- 701
[17] Khatib, R. and Clark, J. A. (1995) "Relevance of culturing Candida species from intravascular catheters." J. Clin. Microbiol. 33(6): 1635-7
[18] Murray, P. R., Baron, E. J., Pfaller, M. A., Tenover, F. C. and Yolken, R.H. (2002) “Manual of clinical microbiology ASM press. Washington D.C.
[19] Odds, F. C. (1988) Candida and candidosis: A review and bibliography. 2nd. Ed., London: Balliere Tindall: 68-92 [20] . Sobel, J. D. (1992) "Pathogenesis and treatment of recurrent vulvovaginal candidiasis." Clin. Infect. Dis. 14 Suppl (1:S1): 48 – 53
[21] Akalm, H., Ener, B., Kahveci, F., Akcaglar, S., Gurcan, S. and Tore, O. (2004) "Persistent of candiduria in ICU catheterized patients is not linked to adherence and proteolytic activities Candida strains." Intens. Care. Med. 30: 972-975
[22] Sobel, J. D. (2002) "Controversies in the diagnosis of candiduria: what is the critical colony count?" Infect. Dis. 4: 81-83
[23] Collier, L., Balows, A. and Sussman, M. (1998) “Topley & Wilson’s Microbiology and microbial infections”.9th Ed, vol 4; Arnold, London, Sydney, Auckland, New Yorke
[24] . el-Ebiary, M., Torres, A., Fabrega, N., Puigdela Bellacasa, J., Gonzalez, J., Ramirez, J., del Bano, D., Hernandez, C. and Jimenez de Anta, T. (1997). "Significance of the isolation of Candida species from respiratory samples in critically ill, non-neutropenic patients. An immediate postmortem histologic study." Am. J. Respir. Crit. Care. Med. 156 (2 Pt 1): 583-90. [25] Gross, N. T, Arias, M. L., Moraga, M., Baddasarow, Y. and Jarstrand, C. (2007) "Species distribution and susceptibility to azoles of vaginal yeasts isolated from prostitutes." Infect. Dis. Obstet. Gynecol. 2007; 2007: 82412.
[26] . Asticcioli, S., Sacco, L., Daturi, R., Matti, C., Nucleo, E., Zara, F. and Pagani, L. (2009) "Trends in frequency and in vitro antifungal susceptibility patterns of Candida isolates from women attending the STD outpatients clinic of a tertiary care hospital in Northern Italy during the years 2002-2007." New. Microbiol. 32(2): 199-204
[27] Mohanty, S., Xess, I., Hasan, F., Kapil, A., Mittal, S. and Tolosa, J. E. (2007) "Prevalence and susceptibility to fluconazole of Candida species causing vulvovaginitis." Indian. J. Med. Res. 126: pp 216 -219
[28] Galle, L. C. and Gianinni, M. J. (2004) "Prevalence and susceptibility of vaginal yeast." J. Bras. Patol. Med. Lab. vol 40 (4): page 229-236
[29] Tulumoglu, S., Kariptas, E. and Erdem, B. (2009) "Identification and antifungal STS reference ID - 2019-02367 susceptibility of Candida isolates from various clinical specimens in Doctor Becchet UZ Hospital." Anatol. J. Clin. Investig. vol 3: page 170 – 173
[30] Baran, J. Jr., Klauber, E., Barczak, J., Riederer, K. and Khatib, R. (2000) "Trends in antifungal susceptibility among Candida sp. urinary isolates from 1994 and 1998." J. Clin. Microbiol. 38(2): 870-1
[31] . Zepelin, M.B-v., Kunz, L., Ruchel, R. and Reichard, U. (2007) "Epidemiology and antifungal susceptibilities of Candida spp to six antifungal agents: results from a surveillance study on fungemia in Germany from July 2004 to August 2005." J.Antimicrob. Chemother. 60(2): 424 – 428
[32] Hamza, O.J., Matee, M.I.N., Moshi, M.T., Simon, E. N.M., Mugusi, F., Mikx, F.H.M., Helderman W.H.P., Rijs, A.J.M., Vanderven A.J.M and Verwij, P. E. (2008). "Species distribution and in vitro antifungal susceptibility of oral yeast isolates from Tanzanian HIV-infected patients with primary and recurrent oropharyngeal candidiasis." BMC. Microbiol. 8: 135
[33] . Bii, C. C., Ouko, T. T., Amukoye, E. and Githinji, L.W. (2002) "Antifungal drug susceptibility of Candida albicans." East. Afr. Med. J. 79(3): 143-5.
[34] . Sachin Chandrakant Deorukhkar, Shahriar Roushan(2018)” Identification of Candida Species: Conventional Methods in the Era of Molecular Diagnosis Ann Microbiol Immunol. 2018; 1(1): 1002
[35] . Mangalkar S M, Sagar K B, Gohel T, Sayare P C “antifungal susceptibility testing in various clinical samples” 2015; 16(2): 440-445
[36] . Vijaya D. et al., Candida Speciation Using Chrom Agar Journal of Clinical and Diagnostic Research. 2011 August, Vol-5(4): 755-757
[37] . L. Sumitra Devi, Megha Maheshwari – Speciation of candida species isolated from clinical specimens using Chromagar and conventional methods ,International Journal of Scientific and Research Publications, Volume 4, Issue 3, March 2014
[38] . Dadhich, et al.: Detection of Candida Species by Hichrom Agar and Their Antimycotic Sensitivity in Hadoti Region International Journal of Scientific Study | July 2016 | Vol 4 | Issue 4
[39]Bharathi “Comparison of chromogenic media with the corn meal agar for speciation of candida” Journal of Pure and Applied Microbiology, ISSN: 2581-690X, Vol: 12, Issue: 3, Page: 1617-1622 (2018)
[40] Pfaller MA, Diekema DJ, Procop GW, Rinaldi MG. Multicenter comparison of the VITEK 2 yeast susceptibility test with the CLSI broth microdilution reference method for testing fluconazole against Candida species. J Clin Microbiol. 2007;45(3):796-802.
[41] Melhem M, Bertoletti A, Lucca H, Silva R, Meneghin F, Szeszs M. Use of the VITEK 2 system to identify and test the antifungal susceptibility of clinically relevant yeast species. Braz J Microbiol. 2013;44(4):1257-66. STS reference ID - 2019-02367
[42] Kaur R, Dhakad MS, Goyal R, Haque A, Mukhopadhyay G. Identification and Antifungal Susceptibility Testing of Candida Species: A Comparison of Vitek-2 System with Conventional and Molecular Methods. J Glob Infect Dis. 2016;8(4):139-146.
[43]Neetu jain et al –Rapid identification of yeast isolates from clinical specimens in critically ill Trauma ICU patients , Journal of Laboratory Physicians / Jan-Jun 2012 / Vol-4 / Issue-1 [44] Giri S, Kindo AJ. Evaluation of antifungalsusceptibility testing in Candida isolates by Candifast and disk-diffusion method. Indian J Pathol M! icrobiol 2014;57:595-7
[45] . Ruchi Goel, Surinder Singh, Amarjit Kaur Gill, Amandeep Kaur, Ivneet Kour. Speciation, characterization and antifungal susceptibility pattern of candida species. International Journal of Contemporary Medical Research 2018;5(5):E1-E4.
[46] Veenu Gupta - SPECIATION AND ANTIFUNGAL SUSCEPTIBILITY PROFILE OF CANDIDURIA CASES AT A TERTIARY CARE HOSPITAL,IJPRBS, 2015; Volume 4(6): 137-144
[47] Tejashree A et al-Speciation and In-vitro antifungal Susceptibility Testing of candida isolates in various clinical samples in a tertiary care hospital in south india , International Journal of Advanced Scientific and Technical Research, Issue 4 volume 5, Sep. – Oct. 2014
[48] Elmer Koneman, Stephen Allen, William Janda, Colour Atlas and Textbook of diagnostic Microbiology, 6th edition 2006
[49] Mine Yucesoy and Serhat Marol,Performance of CHROM agar Candida and BIGGY agar for identification of yeast species, Annuals of Clinical Microbiology and Antimicrobials ; 2;8
[50] Negri et al ,Correlation between E test , Disk Diffusion , and Microdilution methods for antifungal susceptibility testing of Candida species from Infection and Colonisation , Journal of clinical laboratory Analysis,2009,23:324 -330
[51] Gandham NR, Vyawahare CR, Jadhav SV, Misra RN. Candidemia: Speciation and Antifungal susceptibility testing from a Tertiary Care Hospital in Maharashtra, India. Med JDY Patil Univ 2016;9:596- 9.
[52] [52]Neil M. Ampel. Emerging Disease Issues and Fungal Pathogens Associated with HIV infection. Emerging Infectious Diseases 1996; 2:109-116
[53] Nelson M, Wanjiru W, Margaret MW. Prevalence of vaginal candidiasis and determination of the occurrence of Candida species in pregnant women attending the antenatal clinic of Thika District Hospital, Kenya. Open J Med Microbiol. 2013;2013:264–272. STS reference ID - 2019-02367
[54] Anorlu R, Imosemi D, Odunukwe N, Abudu O, Otuonye M. Prevalence of HIV among women with vaginal discharge in a gynecological clinic. J Natl Med Assoc. 2004;96(3):367
[55] . Iman KB, Shorouk KEH, Muhmoud M. Candida infection associated with urinary catheter in critically ill patients. Identification, antifungal susceptibility and risk factors. Res.J. of Med and Med sciences. 2010; 5:79-86
[56] Manikandan C. and Amsath A characterization and susceptibility pattern of Candida species isolate d from urine samples in Pattukkottal,Tamilnadu, India. International journal of pure and applied zoology 2015;3:17-23.
[57] Sagar K, Mangalkar S, Gohel T Isolation of Different Candida Species from Clinical Samples and Comparison between Conventional and Hicrome Technique of Identification International Journal of Science and Research (IJSR) ISSN (Online): 2319-7064.
[58] WadhaAlfouzana,b, , Tahani Al-Enezia , EbteehalAlRoomi. Comparison of the VITEK 2 antifungal susceptibility system with Etest using clinical isolates of Candida speciesVol.34,number 3, page171-174 July –September 2017
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Dr.Karthik R, Dr.Sujatha K Karjigi, & Dr.Surodeep Bhattacharjee. (2025). COMPARATIVE STUDY OF PHENOTYPIC AND AUTOMATED METHODS IN IDENTIFICATION AND ANTIFUNGAL SUSCEPTIBILITY OF CANDIDA SPECIES ISOLATED FROM CLINICAL SAMPLES. Journal of Population Therapeutics and Clinical Pharmacology, 32(5), 739-751. https://doi.org/10.53555/r9tj5k68
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Author Biographies
Dr.Karthik R
Associate Professor, Department of microbiology, Dr.B R Ambedkar Medical college hospital, Bangalore 560045, Karnataka, India.
Dr.Sujatha K Karjigi
Associate Professor,Department of microbiology, Dr.B. R. Ambedkar Medical college hospital, Bangalore 560045, Karnataka, India
Dr.Surodeep Bhattacharjee
Department of microbiology, Dr.B R Ambedkar Medical college hospital, Bangalore 560045, Karnataka, India
How to Cite
Dr.Karthik R, Dr.Sujatha K Karjigi, & Dr.Surodeep Bhattacharjee. (2025). COMPARATIVE STUDY OF PHENOTYPIC AND AUTOMATED METHODS IN IDENTIFICATION AND ANTIFUNGAL SUSCEPTIBILITY OF CANDIDA SPECIES ISOLATED FROM CLINICAL SAMPLES. Journal of Population Therapeutics and Clinical Pharmacology, 32(5), 739-751. https://doi.org/10.53555/r9tj5k68