Jpn. J. Infect. Dis., 58 (6), 344-348, 2005
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Original Article
Emergence of Non-albicans Candida Species and Antifungal Resistance in a Tertiary Care Hospital
Malini Rajinder Capoor*, Deepthi Nair, Monorama Deb, Pradeep Kumar Verma1, Lakshmi Srivastava and Pushpa Aggarwal
Department of Microbiology and 1Intensive Care Unit, Vardhman Mahaveer Medical College and Safdarjung Hospital, New Delhi, 110029, India
(Received February 21, 2005. Accepted August 24, 2005)
*Corresponding author: Mailing address: C-99, Neelambar Apts, Opp. Sainik Vihar, Peetampura, Delhi-110034, India. Tel: +91-1127015569, E-mail: rajeevmalini@rediffmail.com
SUMMARY: The spectrum of candidiasis has changed with the emergence of non-albicans Candida spp. and acquired antifungal resistance, especially in immunocompromised hosts. This changing scenario has necessitated routine antifungal susceptibility testing. In the present work, 102 Candida spp. isolates gathered during 2003 - 2004 were characterized by standard procedures, and antifungal susceptibility testing to amphotericin B, fluconazole and itraconazole was performed by broth macrodilution (BMD)-minimum inhibitory concentration (MIC) and disk diffusion (DD) methods. Among all isolates, 77.4% were from an ICU and 10.8% were obtained from a nursery. The majority of the isolates were C. tropicalis (48%), followed by C. parapsilosis (27.4%) and C. albicans (22.5%). Overall 6.9, 4.9 and 3.9% of all isolates were resistant to amphotericin B, fluconazole and itraconazole, respectively. Out of the 5 (4.9%) isolates resistant to fluconazole, 4 (3.9%) were from patients with AIDS on fluconazole prophylaxis. A discrepancy was observed between the results of susceptibility testing by DD and those by BMD-MIC: 15 (14.7%) isolates were reported to be resistant by DD despite having low MICs. Based on these results, it was concluded that initial antifungal screening of clinical isolates by the DD method followed by confirmation of resistant strains by the broth dilution method is desirable to optimize patient management.