CHARACTERISATION AND ANTIFUNGAL SUSCEPTIBILITY TESTING OF CANDIDA SPECIES ISOLATED FROM CLINICAL SAMPLES OF PATIENTS ATTENDING KATIHAR MEDICAL COLLEGE, KATIHAR, BIHAR

BACKGROUND Of the various candida species, more than 90% of invasive infections are caused by Candida albicans, Candida glabrata, Candida parapsilosis, Candida tropicalis, Candida krusei, Candida dubliniensis and Candida lusitaniae. Clinical manifestations range from mucocutaneous overgrowth to disseminated infections like candidaemia. Virulence factors like tissue adhesion, phenotypic switching and production of extracellular hydrolytic enzymes are responsible for colonisation and invasion of host tissues along with host factors like immunocompromised states. The aim of this study is to characterise candida strains isolated from patients and to study their anti-fungal susceptibility pattern. MATERIALS AND METHODS Samples such as pus, sputum, blood and urine were collected from patients attending OPD's and IPD's of Medicine, Surgery, Obstetrics and Gynaecology, Paediatrics and Casualty. In this study, primary isolation was done on blood and Sabouraud's dextrose agar from clinical samples. Species were identified based on production of coloured colonies on HiCrome agar and other phenotypic tests like germ tube and chlamydospores formation, sugar fermentation and assimilation tests. Statistical Analysis Statistical analysis was carried out using online statistical software at http://www.physics.csbsju.edu/stats/contingency_NROW_NCOLUMN_form.html. Chi-square test was used to determine the probability. Study Design- This descriptive study was conducted in the Department of Microbiology, Katihar Medical College, Katihar, Bihar. RESULTS Candida species isolated were Candida albicans 38.5% followed by Candida famata 22.2%, Candida guilliermondii 17%, Candida tropicalis 6.7%, Candida kefyr 5.2%, Candida dubliniensis 3%, Candida glabrata and Candida parapsilosis 2.2% each and Candida lusitaniae and Candida catenulata 1.5% each. Modified Kirby Bauer's Disc Diffusion method was used for performing anti-fungal susceptibility tests. Candida albicans and non-albicans candida were most sensitive to voriconazole (73.1% and 84.3%) and most resistant to miconazole (51.9% and 66.3% respectively). CONCLUSION Candida albicans was the most frequently isolated species in the present study. Candida species was isolated most frequently from urine samples followed by vaginal swab and sputum. Highest number of candidiasis patients were from Departments of Obstetrics and Gynaecology 57.0% followed by Paediatrics 17.8% and Medicine 14.1%. Candida albicans was the most commonly isolated candida species, 38.5%. Maximum number of Candida albicans strains showed dose-dependent sensitivity with nystatin 76.9%. NAC species showed resistance to miconazole 66.3% followed by ketoconazole 47% and fluconazole 25.03%.