Biotyping molecular characterization and antifungal susceptibility of Candida species isolated from various clinical specimens in a rural tertiary care hospital of western Maharashtra

Abstract

In recent years, incidence of mycotic infections in general and candidiasis in particular has increased. Candida spp. is the only mycotic pathogen capable of causing broad spectrum of clinical manifestations ranging from mucocutaneous overgrowth to disseminated infections. Although Candida albicans is considered as the most pathogenic member of genus, the shift towards less common or cryptic Snon albicans Candida (NAC) species is evident in recent years. C. albicans and NAC spp. are closely related and cause clinically indistinguishable manifestations however, they differ from each other with respect to epidemiology, virulence factors and more important the antifungal susceptibility. The purpose of this study was to determine the species distribution, virulence factors, antifungal susceptibility profile and molecular characterization of Candida isolates from various clinical specimens. newlineMaterials and methods: The present descriptive cross sectional study was conducted in the Department of Microbiology, Rural Medical College, Loni, Maharashtra. Candida isolates from various clinical specimens were identified upto species level as per standard mycological protocol. Virulence factors like biofilm formation, invitro production of exoenzymes, haemolytic activity and adherence to human buccal epithelial cell (HBEC) were studied. Antifungal susceptibility profile of isolates was screened by disc diffusion method and confirmed by theClinical and Laboratory Standards Institute (CLSI) reference broth microdilution (BMD) method. Echinocandin susceptibility profile of Candida spp. isolated from candidemia cases was studied. Molecular characterization of prevalent Candida spp with special reference to fluconazole resistance was done. newlineResults:Candida species were isolated from a total of 701 (11.4%) samples. Majority of isolates were from urine specimens followed by vaginal swabs. Predominance of NAC spp.(77.1%) over C. albicans (22.9%) was noted. C. tropicalis (35.2%) followed by C. glabrata (23.9%) and C. kr