Isolation, speciation and antifungal susceptibility testing of Candida isolates from various clinical specimens at a tertiary care hospital, Nepal

• Published in: BMC research notes Vol. 10; no. 1; p. 218
• Main Authors: Khadka, Sundar, Sherchand, Jeevan Bahadur, Pokhrel, Bharat Mani, Parajuli, Keshab, Mishra, Shyam Kumar, Sharma, Sangita, Shah, Niranjan, Kattel, Hari Prasad, Dhital, Subhash, Khatiwada, Sulochana, Parajuli, Narayan, Pradhan, Manoj, Rijal, Basista Prasad
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 24.06.2017; BioMed Central; BMC
• Subjects: Agar; Antifungal agents; Antifungal Agents - pharmacology; Antifungal susceptibility testing; Candida; Candida albicans - classification; Candida albicans - drug effects; Candida albicans - isolation & purification; Candida glabrata - classification; Candida glabrata - drug effects; Candida glabrata - isolation & purification; Candida tropicalis - classification; Candida tropicalis - drug effects; Candida tropicalis - isolation & purification; Candidiasis - drug therapy; Candidiasis - epidemiology; Candidiasis - microbiology; CHROMagar; Clotrimazole; Clotrimazole - pharmacology; Cross-Sectional Studies; Dextrose; Drug resistance; Drug Resistance, Fungal - physiology; Female; Fluconazole; Fluconazole - pharmacology; Fungal infections; Health risk assessment; Humans; Hydrolysis; Identification and classification; Male; Miconazole; Miconazole - pharmacology; Microbial Sensitivity Tests; Mycological Typing Techniques; Nepal - epidemiology; Physiological aspects; Severity of Illness Index; Speciation; Species; Tertiary Care Centers; Urea; Urine; Yeast; Nepal; CHROMagar; Antifungal susceptibility testing; Candida
• ISSN: 1756-0500; 1756-0500
• DOI: 10.1186/s13104-017-2547-3

Candida species are responsible for various clinical infections ranging from mucocutaneous infection to life threatening invasive diseases along with increased resistance to antifungal drugs has made a serious concern. Resistance to antifungal agents has increased during the last decade. Thus, identification of Candida up to species level and its antifungal susceptibility testing has a paramount significance in the management of Candidal infections. The aim of the study was to speciate Candida species and to determine antifungal susceptibility pattern of Candida species to antifungal agents. A total of 100 consecutive Candida species were isolated from 1248 clinical specimens over 7 months period. Growths on Sabouraud dextrose agar were evaluated for colony appearance, macroscopic examination, Gram staining, germ tube test and urea hydrolysis test. Further, they were processed for Candida speciation on CHROMagar. Antifungal susceptibility testing was performed as recommended by Clinical and Laboratory Standards Institute (CLSI) M44-A document. Out of 100 Candida isolates, Candida albicans (56%) was the most common species. Among the non-albicans Candida species, Candida tropicalis (20%) was the predominant isolate followed by Candida glabrata (14%). Regarding antifungal susceptibility pattern, Candida species were more susceptible to clotrimazole (82%) followed by fluconazole (64%) and miconazole (44%). Candida albicans was the predominant species responsible for various Candidal infections. Among commonly used antifungal drugs clotrimazole, miconazole and fluconazole were most effective.