Emerging azole resistance in clinical isolates of Candida species causing bloodstream infection in a tertiary care hospital, Kolkata - A cross-sectional observational study

Subhendu Sikdar; Suranjan Pal; Reena Ray; Mitali Chatterjee; Maitreyi Bandyopadhyay

doi:10.5455/njppp.2023.13.09438202312122023

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Online Publishing Date:
11 / 01 / 2024

Natl J Physiol Pharm Pharmacol. 2024; 14(6):

doi: 10.5455/njppp.2023.13.09438202312122023

Emerging azole resistance in clinical isolates of Candida species causing bloodstream infection in a tertiary care hospital, Kolkata - A cross-sectional observational study

Subhendu Sikdar, Suranjan Pal, Reena Ray, Mitali Chatterjee, Maitreyi Bandyopadhyay.

Abstract
Background: Candida-associated bloodstream infections (BSI) are one of the major causes of nosocomial mortality. The changing spectrum of candidemia with respect to increased isolation of non-albicans Candida (NAC) along with the susceptibility pattern underlines the necessity of rapid and appropriate diagnosis of pathogenic Candida along with antifungal susceptibility to institute prompt and appropriate antifungal therapy.

Aims and Objectives: The aim of the present study is to determine the prevalence of Candida isolates causing BSI along with the changing trend of its species-specific aetiology and susceptibility pattern in a tertiary care hospital in Kolkata.

Materials and Methods: Candida species isolated from positive blood cultures were speciated conventionally as per standard laboratory protocol. Virulence factors were determined phenotypically on sabouraud dextrose agar with blood, egg yolk agar, and tween 80 agar. Adherence and biofilm production were also detected. Antifungal susceptibility was performed by the disk diffusion method as per clinical and laboratory standards institute guidelines.

Results: Out of a total of 3987 blood samples collected during a period of 1 year, 73 (1.83%) showed growth of Candida, among which the majority was NAC (61.64%). Out of them, Candida tropicalis (23.28%) was the predominant species, followed by Candida guilliermondii (19.18%). Males (61.64%) outnumbered females. Age groups <10 years were most affected. Major risk factors were prolonged intensive care unit stays, diabetes, and the presence of a central venous catheter. 93.15% of Candida produced hemolysin, 83.56% phospholipase, and 68.49% esterase. 79.45% of species showed adherence, and 52.05% produced biofilm. Antifungal susceptibility showed lower resistance to amphotericin B, where a higher incidence of azole resistance among NAC species was observed.

Conclusion: The detection of Candida species along with their antifungal susceptibility will help in better comprehension of the changing patterns of Candida for better management and prognosis of patients.

Key words: Prevalence; Candidemia; Virulence; Susceptibility; Candida Associated Bloodstream-Infections

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How to Cite this Article

Pubmed Style

Sikdar S, Pal S, Ray R, Chatterjee M, Bandyopadhyay M. Emerging azole resistance in clinical isolates of Candida species causing bloodstream infection in a tertiary care hospital, Kolkata - A cross-sectional observational study. Natl J Physiol Pharm Pharmacol. Online First: 11 Jan, 2024. doi:10.5455/njppp.2023.13.09438202312122023

Web Style

Sikdar S, Pal S, Ray R, Chatterjee M, Bandyopadhyay M. Emerging azole resistance in clinical isolates of Candida species causing bloodstream infection in a tertiary care hospital, Kolkata - A cross-sectional observational study. https://www.njppp.com/?mno=168833 [Access: March 15, 2024]. doi:10.5455/njppp.2023.13.09438202312122023

AMA (American Medical Association) Style

Sikdar S, Pal S, Ray R, Chatterjee M, Bandyopadhyay M. Emerging azole resistance in clinical isolates of Candida species causing bloodstream infection in a tertiary care hospital, Kolkata - A cross-sectional observational study. Natl J Physiol Pharm Pharmacol. Online First: 11 Jan, 2024. doi:10.5455/njppp.2023.13.09438202312122023

Vancouver/ICMJE Style

Sikdar S, Pal S, Ray R, Chatterjee M, Bandyopadhyay M. Emerging azole resistance in clinical isolates of Candida species causing bloodstream infection in a tertiary care hospital, Kolkata - A cross-sectional observational study. Natl J Physiol Pharm Pharmacol, [cited March 15, 2024]; Online First: 11 Jan, 2024. doi:10.5455/njppp.2023.13.09438202312122023

Harvard Style

Sikdar, S., Pal, . S., Ray, . R., Chatterjee, . M. & Bandyopadhyay, . M. (2024) Emerging azole resistance in clinical isolates of Candida species causing bloodstream infection in a tertiary care hospital, Kolkata - A cross-sectional observational study. Natl J Physiol Pharm Pharmacol, Online First: 11 Jan, 2024. doi:10.5455/njppp.2023.13.09438202312122023

Turabian Style

Sikdar, Subhendu, Suranjan Pal, Reena Ray, Mitali Chatterjee, and Maitreyi Bandyopadhyay. 2024. Emerging azole resistance in clinical isolates of Candida species causing bloodstream infection in a tertiary care hospital, Kolkata - A cross-sectional observational study. National Journal of Physiology, Pharmacy and Pharmacology, Online First: 11 Jan, 2024. doi:10.5455/njppp.2023.13.09438202312122023

Chicago Style

Sikdar, Subhendu, Suranjan Pal, Reena Ray, Mitali Chatterjee, and Maitreyi Bandyopadhyay. "Emerging azole resistance in clinical isolates of Candida species causing bloodstream infection in a tertiary care hospital, Kolkata - A cross-sectional observational study." National Journal of Physiology, Pharmacy and Pharmacology Online First: 11 Jan, 2024. doi:10.5455/njppp.2023.13.09438202312122023

MLA (The Modern Language Association) Style

APA (American Psychological Association) Style

Sikdar, S., Pal, . S., Ray, . R., Chatterjee, . M. & Bandyopadhyay, . M. (2024) Emerging azole resistance in clinical isolates of Candida species causing bloodstream infection in a tertiary care hospital, Kolkata - A cross-sectional observational study. National Journal of Physiology, Pharmacy and Pharmacology, Online First: 11 Jan, 2024. doi:10.5455/njppp.2023.13.09438202312122023

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