SPECTRUM OF CANDIDA SPECIES AND ANTIFUNGAL SUSCEPTIBILITY PATTERN IN BLOODSTREAM INFECTIONS AT A TERTIARY CARE CENTRE

Abstract

Background: Candidemia is a major cause of morbidity and mortality in hospitalized patients, particularly in intensive care units. Recent trends indicate a shift from Candida albicans to non-albicans Candida species, along with increasing antifungal resistance, posing significant therapeutic challenges. Aim: To study the epidemiological profile and antifungal susceptibility pattern of Candida species isolated from bloodstream infections in a tertiary care hospital. Objectives: To determine the species distribution of Candida isolates from blood samples.  To analyze demographic and clinical characteristics of affected patients. To evaluate antifungal susceptibility patterns of Candida isolates.  Materials and Methods: This was a cross-sectional retrospective observational study conducted in a tertiary care hospital. A total of 8411 blood samples were processed, out of which 75 Candida isolates were identified. Species identification was performed using standard microbiological techniques. Antifungal susceptibility testing was carried out for commonly used antifungal agents. Demographic and clinical data were collected and analyzed using appropriate statistical methods. Results: Out of 8411 blood samples, 75 (0.89%) were positive for Candida species. A total of 9 different species were identified, with predominance of non-albicans Candida species. Candida tropicalis was the most common isolate (33.33%), followed by Candida parapsilosis (20.0%) and Candida albicans (14.66%). Male patients constituted 60% of cases. Majority of infections were observed in ICU patients (82.66%). The highest incidence was noted in the elderly age group (71–80 years). Antifungal susceptibility testing revealed high resistance to Fluconazole (29.1%). Voriconazole and echinocandins (Caspofungin and Micafungin) showed excellent sensitivity, while Amphotericin B retained good efficacy (89.8%). Conclusion: The study demonstrates a predominance of non-albicans Candida species with increasing antifungal resistance, particularly to Fluconazole. ICU patients and elderly individuals are at higher risk of candidemia. Routine surveillance, antifungal susceptibility testing, and implementation of antifungal stewardship programs are essential for effective management and improved clinical outcomes.