Frequency and Antifungal Susceptibility Patterns of Candida Species Isolated from Clinical Samples of Patients Attending to a Tertiary Healthcare Setting in Karnataka, India

Abstract

Context: Candida species are common pathogens causing a range of infections from mucocutaneous to systemic. The increasing antifungal resistance among Candida species presents a substantial challenge in healthcare settings. Aims: This study examines the distribution and antifungal susceptibility patterns of Candida species to provide insights into regional epidemiology and resistance. Settings and Design: A retrospective, observational, single-center study was conducted to analyze the distribution of Candida species in various clinical samples and their antifungal susceptibility patterns at Justice K. S. Hegde Charitable Hospital, a 1000-bed tertiary healthcare teaching hospital in Mangalore. Subjects and Methods: Candida identification was performed using automated identification systems, while antifungal susceptibility testing was done using the VITEK 2 AST YS08 system. Relevant clinical information from electronic medical records of all positively identified Candida species cases was reviewed and recorded. Statistical Analysis Used: Statistical Package for Social Sciences (SPSS) software version 20 was used to evaluate, code, verify, and statistically analyze the acquired data. Results: In total, 701 Candida isolates were identified, with C. albicans being the most common species (290, 41.4%). Among non-albicans Candida, C. tropicalis (209, 29.8%) was predominant, followed by C. parapsilosis (91, 13%), C. glabrata (32, 4.6%) and C. krusei (32, 4.6%). Resistance patterns showed C. krusei and Candida auris had the highest resistance to fluconazole and voriconazole. Sensitivity was highest for micafungin and caspofungin. Most patients had type 2 diabetes or hypertension as comorbidities. Conclusions: Resistance patterns varied by species, revealing differences from international studies. The results underscore the importance of ongoing local surveillance and epidemiological studies to monitor antifungal resistance. Understanding species distribution and resistance mechanisms is essential for effective treatment strategies and controlling invasive Candida infections. Enhanced local data can help in optimizing antifungal therapies and preventing resistance.

Keywords

• antifungal susceptibility
• antifungals
• candida
• infection
• mycology