 |
| About Bioline | All Journals | Testimonials | Membership | News |
|
||||||
|
||||||
Indian Journal of Medical Microbiology, Vol. 24, No. 1, January-March, 2006, pp. 80-81 Correspondence Antibiotic susceptibility of Candida isolates in a tertiary care hospital in Southern India. Srinivasan L, Kenneth *J Department of Laboratory Medicine, Sagar Apollo Hospital, Bangalore - 560 064, Karnataka, India Correspondence Address: Kenneth *J, E-mail: john.kenneth@lvpei.org Code Number: mb06024 Dear Editor, Systemic infections due to yeasts and resistance to antifungals is on the rise in Indian hospitals.[1] Candida albicans accounts for 40-60% of yeasts isolated in developed countries[2] whereas Indian reports show an increased predominance of non C. albicans isolates. [1] Increasing resistance to azoles and amphotericin B has been reported both from India and other countries.[1],[2] Given the paucity of data from southern India on the profile of yeast isolates and prevailing patterns of susceptibility to antifungals we speciated 77 yeasts obtained from culture of clinical specimens [Respiratory 22 (27.8%), blood 22 (25.3%), vaginal 12 (15.2%), urine 13 (16.5%) and others 10 (12.7%)] and estimated susceptibility to antifungal drugs. The study period was from September 2004 to March 2005. Isolates of Candida were identified by Gram stain of colony morphotypes suggestive of yeasts and were presumptively reported as C. albicans or Candida spp . based on the positive or negative germ tube test. Species level identification and antifungal susceptibility were done using the API ID 32C for identification and ATB Fungus 2 (bioMerieux, France).[3] Manufacturers' instructions were strictly followed and adequate quality control measures were undertaken to ensure sterility and efficacy of media and reagents used. The distribution of Candida spp. and their susceptibility is portrayed in the [Table - 1]. The common isolates were C. albicans 36 (47%), Candida tropicalis 18 (23%) and Candida pelliculosa 5 (6%). These three species accounted for 76% of Candida isolates. C. pelliculosa was isolated only from blood cultures of newborn in the neonatal ICU. Germ tube test was positive in 89% of isolates speciated as C. albicans and 5% of C. tropicalis. The loss of susceptibility of C. albicans to azoles (fluconazole -30% and itraconazole 75%) is of concern although amphotericin B and flucytosine continue to show good efficacy. It is necessary to start presumptive therapy with either of these two antifungals when C. albicans is reported. Of the other Candida species only C. pelliculosa showed 100% susceptibility to the azoles. Flucytosine displays no efficacy against C. pelliculosa , C. krusei and C. parapsilosis. With multiple antifungals and varying susceptibility patterns of Candida it has now become necessary to perform antifungal susceptibility testing real-time and make reports available to the clinician for effective therapeutic outcome. References
Copyright 2006 - Indian Journal of Medical Microbiology The following images related to this document are available:Photo images[mb06024t1.jpg] |
| |||||||||
