A retrospective investigation of Candida spp. and its antifungal susceptibility profile in cancer patients at a South Indian tertiary care hospital

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Original Article

Author Details : Varalakshmi Vijayakumar*, Jennifer Emelda, Venkataraman Radhakrishnan, Saraswathi Subramani

Volume : 9, Issue : 3, Year : 2023

Article Page : 167-176

https://doi.org/10.18231/j.ijmmtd.2023.033

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Abstract

Background: Among the most frequently recognized pathogenic fungi, Candida spp. from Clinical samples plays a vital role. In recent decades, poor antifungal therapy usage critically in immunocompromised patients has led to antifungal drug resistance among Candida. Hence, expeditious
and dependable species identification is crucial for the effective implantation of treatment strategies and the management of diseases.
Aim & Objectives: The purpose of the study was to look at the presence of Candida in various Clinical samples taken from cancer patients who are being treated at a tertiary care hospital in South India. The primary objective of this investigation is to ascertain the susceptibility patterns shown by antifungal drugs. This retrospective investigation was undertaken between January 2022 to April 2023.
Materials and Methods: The Candida isolates were subjected to antifungal susceptibility (AFST) by both Conventional (disc diffusion assay) and Automated methods (VITEK-2 compact - AST YSO1). The susceptibility pattern was recorded against antifungal agents like Fluconazole (FLU), Voriconazole (VOR), Amphotericin B (AMB), and Caspofungin. Candida spp. was identified by conventional method (Chrome ID) as per standard laboratory protocols and by an automated method using MALDI – TOF. 
Results: Among 215 samples received from cancer patients suggestive of Candidiasis, Candida albicans (64.6%) was the predominant isolate, and the lowest one was C. parapsilosis (2.25%). Male patients had a higher prevalence of Candida (55.8%). Similarly, the prevalence was higher in patients over 60, with male patients having an incidence of 38.3% and female patients having 23%. By disk diffusion assay C. albicans and C. tropicalis showed 100% sensitivity to all antifungals used in this study. 
Conclusion: We conclude that the disc diffusion assay is a more cost-effective, user-friendly, and effective screening test than the VITEK 2, and it has the potential to be used as a workable method for Antifungal susceptibility test. The use of Chrome ID for identification of Candida spp. is cost-effective and reliable. However, MALDI TOF has the advantage of rapidity, providing correct findings promptly. The timely delivery of diagnostic reports facilitates early diagnosis of patients. Therefore, it is recommended in this research to use MALDI TOF for the identification of Candida spp. and the disc diffusion technique for antifungal susceptibility testing (AFST).

Keywords: Candida spp. Antifungal Susceptibility Testing, Disk Diffusion, MALDI -TOF

How to cite : Vijayakumar V, Emelda J, Radhakrishnan V, Subramani S, A retrospective investigation of Candida spp. and its antifungal susceptibility profile in cancer patients at a South Indian tertiary care hospital. IP Int J Med Microbiol Trop Dis 2023;9(3):167-176

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