Candidemia profile and antifungal drugs susceptibility pattern in neonatal intensive care unit patients in a tertiary care teaching institute in Maharashtra

  • Vanita Ashok Kulkarni
  • Arati Ankushrao Bhadade Assistant professor, department of microbiology, government medical college, Nagpur.
  • Shilpa Dayanand Putta
Keywords: Antifungal drug resistance, AFST, Candidemia, NICU


Background: Invasive candidiasis is one of the most commonly encountered problems in neonatal intensive care unit (NICU) leading to substantial morbidity and mortality. Recent studies show an increase in antifungal resistance of candida species. Therefore, species identification with antifungal susceptibility pattern of Candida isolates is very important and helps in the selection of appropriate antifungal agents to prevent the emergence of drug resistance and successful treatment.Methods: Seven thirty four blood culture samples from 244 patients of NICU were tested. Yeast isolates from these blood cultures were identified by conventional methods. Anti-fungal susceptibility testing was done according to CLSI M44A guidelines for Fluconazole, Voriconazole, ketoconazole, Amphotericin-B and Itraconazole.Result: From 118 isolates c. albicans were 37.28 % and remaining 62.72% were non-albicans candida species including c.glabrata (28.81%), c.parapsilosis (14.4%), c.tropicalis (12.71%) and other (6.77%). From all isolates of candida species, Fluconazole, Amphotericin B and ketoconazole were sensitive in 61.0%, 86.4% and 99.1% patients respectively. Voriconazole and Itraconazole were 100% sensitive.Conclusion: Although previously Candida albicans accounted for majority cases of candidiasis, recently NAC species have been increasingly reported in neonatal intensive care units. Amphotericin B should be reserved for life threatening conditions and extended spectrum azole drugs like Voriconazole, Itraconazole and ketoconazole can be good alternatives for treating these infections.DOI: 10.21276/APALM.2017.1000


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Original Article