A prosp.ective study on prevalence of Candida species in clinical samples

Abstract

lnfections caused by opportunistic pathogens, e.g. yeasts are important reasons of morbidity and mortality throughollt the world. Ca1ldida spp. are true opportun istic pathogens that enters in the circu lation and deep tissues. This causes many deaths annua lly in Pakistan and is one of the seriolls public health concerns of snJdy area. This work was conducted (0 study the prevalence of Candida spec ies in clin ica l samples from Quaid·i-Azam International Hospita l (Qfl-l) Islamabad) Pakistan during March to December 20 13. A lotal of3007 clinical samples were collected from both in-door and out-door patients, in whi ch only 255 were Candida positive. Candida spec ies were isolated and identified using clinica l, cultural, biochemi ca l and molecular methods. Morphological identification was done by using differen t growth media. Further identification was dOlle through gram st3ini ng and ge rm lube. Among 255 isolates, 128 were germ tube positive and 127 were germ tube negative. Comparison of two differential media i.e. Chrome agar Cmldida and Corn Meal agar was also done, showing that Corn Mea l agar was better media for rapid identificat ion of all Candida species. On the basis of growih on Chrome-agar and Corn Meal agar [2~ (5 1 %) iso lates were C. albicans. rollowed by 30 (12%) C. glabrafa, 26 ( 10%), C. 'ropicalis, 17 (7%) C. krllsei and 19 (7.5%) were other Candida spp. while other Candida spp. were fu rther identified on Corn Mea l agar. Twelve (5%) isolates were of C. paropsilosis, 3 (2%) isolates were of C. dllhiiniemfs and C. l usifanfa while 1 (0.4%) isolate was of T";chosporol/1Il species. These resu lts we re further confirmed by using commercia1Jy ava ilable analytica l profil e index (API IOC) kil, which show 100% si milarity with both differential media. Antifungal susceptibility tests of three predominant ly used antifungals i.e. fluconazole, voriconazole and amphotericin B showed that Candida species showed bad high resistance to nuconazole ( 14.5%) and increase sensitivity to amphotericin B (J 0%). The presence of Candida spp. was fu rther confirmed by amplification orDNA oflTS region hy peR and .<;equencing. ft is concluded that on the basis of present work C. albicans is the major specie Rmong a[l Candida species causing candidemia. It is need of furthe r wo rk to give concentrated evidence in the prevalence of Candida infections in the local area.