Speciation and Antifungal Susceptibility of Clinical Non-albicans Candida isolated from Patients in a Tertiary Care Centre in Egypt

Document Type : New and original researches in the field of Microbiology.

Authors

1 Microbiology Department, Theodor Bilharz Research Institute (TBRI), Egypt

2 Medical Microbiology and Immunology Department, Faculty of Medicine, Cairo University

Abstract

Background: There has been a significant rise in morbidity and mortality due to infections caused by Candida spp. with an upsurge in the incidence of non-albicans Candida (NAC), where the clinical outcome is affected by their decreased susceptibility to azoles. Accurate identification is an important step that leads to selecting a suitable antifungal agent. Objectives: This study aimed to identify the main NAC clinical spp. in the hospital setting and to determine the antifungal susceptibility. Methodology: 133 isolates of Candida were identified by culture on Sabouraud Dextrose Agar, Gram stain, and germ tube test. Isolates were then subcultured on HiCrome chromogenic agar medium, and identification was confirmed using Vitek 2 automated compact system. NAC isolates antifungal susceptibility was detected using disk diffusion method and Vitek 2 compact system. Results: The majority of the Candida isolates (75%) were identified as NAC spp. with C. glabrata predominance (96%). HiCrome showed a sensitivity of 97% compared to Vitek 2 system. Disk diffusion showed high sensitivity when tested with amphotericin B, fluconazole, voriconazole and caspofungin of 100%, 95.2%, 100%, and 92.86% respectively compared to Vitek 2. Conclusion: This study confirms the substantial shift in Candida spp. from albicans to NAC. HiCrome chromogenic agar medium could be used as a rapid method for identification of the common NAC spp. Disk diffusion represents a reliable alternative method for routine antifungal susceptibly testing in the absence of automated systems.

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