INVESTIGATING THE ANTIFUNGAL SUSCEPTIBILITY PATTERN OF CANDIDA ALBICANS ISOLATED FROM DIFFERENT CLINICAL SAMPLES BY KIRBY-BAUER DISC DIFFUSION AND BROTH MICRODILUTION METHOD TO FLUCONAZOLE AND AMPHOTERICIN B
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Keywords
Candida albicans, Antifungal Susceptibility, Antifungal resistance, Disc diffusion method, Microdilution method
Abstract
Introduction: Candidiasis is a severe fungal infection caused mostly by Candida albicans in humans. Candida albicans is an opportunistic infection in immunocompromised persons that has proven lethal despite antifungal treatment. The rise in antibiotic resistance in C. albicans is alarming, as it is in the human microbiome.
Aim and Objective: To detect the antifungal sensitivity pattern of Candida albicans isolated from various clinical samples to Fluconazole and Amphotericin B using the Kirby Bauer disc diffusion method and the Broth microdilution method.
Materials and Methods: This was a cross sectional study carried out in the Department of Microbiology at a tertiary care centre, Uttar Pradesh for a period of 1 year i.e, January 2023 to January 2024. A total of 75 isolates of Candida species from different clincal specimens like blood, BAL, urine, Pus, Et secreation and vaginal secreation were evaluated for its susceptibility against Fluconazole and Amphotericin B using Kirby Bauer disc diffusion method and Broth micro dilution method according to the CLSI guidelines 2023.
Results: In the present study out of 75 isolates of Candida species 30 (40%) isolates were confirmed to be C.albicans. The ratio of Males 19 (63.3%) was more as compared to that of the Females 11( 36.6%) with the maximum age of 31-40 being affected the most followed by 41-50 and least in the age group above 61 years of age. The number of isolates was maximum in the urine sample with 50%.
Out of 75 isolates a total of 30 isolates of Candida albicans were isolated. A total of 13 (43.3%) samples of Candida were sensitive and 17 (56.6%) samples were resistant to Amphotericin B and 27(90%) samples of Candida were sensitive and 3(10%) samples were resistant to Fluconazole by Kirby bauer disc diffusion method.93.3% were sensitive whereas 2 (6.6%) were resistant against Amphotericin B and 25 isolates(83.3%) were sensitive and 5 isolates (16.6%) were resistant to Fluconazole by broth microdilution method.
Conclusion:
The Antifungal susceptibility testing by broth microdilution method revealed that fluconazole was exceedingly resistant against Candida albicans (16.6%) and increasingly susceptible to Amphotericin B( 93.3%). Antifungal susceptibility testing could be used to predict clinical response or management failure. As a result, proper antifungal drug administration should only be prioritised after susceptibility testing.
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Shrawan Kumar
Professor and Head Department of Medicine, Rama Medical College Hospital and Research Centre, Kanpur, Uttar Pradesh, India
Nilam Nigam
Professor and Head, Department of Pharmacology, Rama Medical College Hospital and Research Centre, Mandhana, Kanpur, India.
Kalpana Kuntal
Senior Resident Department of Microbiology, King George Medical University, Lucknow, India.
Nashra Afaq
Research Associate Department of Microbiology and Central Research Laboratory, Rama Medical College Hospital and Research Centre, Kanpur, Uttar Pradesh, India.
Saif Anees
Assistant Professor Department of Community Medicine, Dr. B.R. Ambedkar Govt Medical College Kannauj, India.
Vinay Shekhar Srivastava
Junior Resident Department of Microbiology, Maa Vindhyawasini Autonomous State Medical College Mirzapur, Visundarpur, Mirzapur, India