Speciation of Candida Isolated From Various Clinical Samples & Their Susceptibility Pattern at Tertiary Care Hospital

Abstract

Background: Candida species are important opportunistic pathogens, with a rising trend of non-albicans Candida (NAC) infections and increasing antifungal resistance. Rapid identification and susceptibility testing are essential for effective management.

Aim: To determine the species distribution of Candida isolates from various clinical specimens and evaluate their antifungal susceptibility patterns at a tertiary care hospital in Aurangabad.

Methods: A prospective observational study was conducted from January to December 2021. Clinical samples yielding Candida isolates were processed using the VITEK 2 Compact system for species identification and antifungal susceptibility testing against six agents (fluconazole, voriconazole, amphotericin B, caspofungin, micafungin, and flucytosine).

Results: Out of 244 isolates, Candida tropicalis (31.97%) was the predominant species, followed by C. albicans (22.95%). NAC species constituted 77.05% of isolates, with urine (36.89%) and sputum (19.26%) being the most common specimen sources. C. albicans showed complete susceptibility to amphotericin B and echinocandins, while reduced activity was noted for fluconazole (91%) and flucytosine (87.5%). C. tropicalis retained high susceptibility to amphotericin B (100%) and voriconazole (96%), but fluconazole susceptibility was lower (78.2%). Other NAC species demonstrated >90% susceptibility to amphotericin B, echinocandins, and voriconazole, but flucytosine resistance was higher (15%).

Conclusion: The study highlights an epidemiological shift toward NAC species, particularly C. tropicalis. While amphotericin B and echinocandins remain highly effective, emerging resistance to azoles and flucytosine underscores the need for rapid species identification and localized susceptibility data to guide antifungal therapy.