COMPARISON OF INCIDENCE, RISK FACTORS, OUTCOME AND ANTIFUNGAL SUSCEPTIBILITY BETWEEN CANDIDA ALBICANS AND NON-ALBICANS CANDIDA SPECIES IN PATIENTS OF CANDIDEMIA IN INTENSIVE CARE SETTING

Candidemia is associated with a high mortality. The most common cause of candidemia is Candida albicans, though infections by non-albicans Candida are being increasingly reported. The present study was conducted to determine the incidence of candidemia, the risk factors and antifungal susceptibility in intensive care unit (ICU). This study was conducted from January 2012 to June 2013 and prospectively included patients admitted in ICU for >48 hours. The blood culture isolates were identified as per standard mycological procedures and DNA (26S rDNA) sequencing. Antifungal susceptibility test was carried out by broth micro-dilution method in accordance with CLSI standards. A total of 48 isolates were identified in 1890 ICU admissions. Majority of the isolates were identified as non-albicans Candida i.e. 38 out of 48 isolates which is 79.2% while only 10 isolates were that of Candida albicans i.e. 20.8%. Among the non albicans species, Candida tropicalis (42.1%) was the predominant one followed by Candida rugosa (26.3%), Candida parapsilosis (15.8%) while Candida pelliculosa, Candida glabrata, Candida lusitaniae and Kodamea ohmeri were identified from one case each i.e. 2.6% and two were Candida auris (5.3%). The association of central venous catheter with non-albicans Candida species was found to be statistically significant (P = 0.01). There was significant resistance among Candida auris and Candida rugosa isolates to commonly used antifungals hence it is important to diagnose the infection during its early course for a good outcome.