Isolation, identification, speciation and antibiotic susceptibility pattern of Candida causing bloodstream infection in ICU patients

Blood stream infections (BSI) caused by Candida species are a significant cause of morbidity and mortality in hospitalized patients. Although Candida albicans has been the most common Candida species isolated from BSI’s, there is an increasing trend of isolation of non-albicans Candida from BSI. With the shift to non-albicans Candida species, antifungal resistance has become a major cause of concern in the management of candidemia. In the present study, a total of 100 patients who were admitted in ICU’s of different departments of Victoria hospital, Bangalore Medical College and Research Institute who developed signs and symptoms of nosocomial BSI were screened. Two blood samples were collected and inoculated onto BHI broth, incubated and subcultured onto blood agar and MacConkey agar after 24 hrs incubation. Growth was subjected to Gram’s stain and subcultured onto Sabouraud’s dextrose agar. Speciation and drug susceptipility pattern of candida isolates was determined by BD Phoenix TM Automated Microbiology System. Out of 100 samples, only 2 were positive for Candida. Both were Candida krusei species and found resistant to fluconazole. Increased use of fluconazole has been implicated in shift to non albicans Candida causing BSI and this study confirms it. This study illustrates the importance of Candida in causing BSI and change in species distribution from albicans to non-albicans Candida and their resistance pattern which helps in formulating antibiotic policy of the hospital.