ANTIFUNGAL SUSCEPTIBILITY TESTING OF CANDIDA SPECIES ISOLATED FROM BLOOD STREAM INFECTION BY USE OF VITEK 2 SYSTEM

BACKGROUND Candida blood stream infections have increased drastically by 2 to 5 folds in a tertiary care hospital over the past decade. In spite of advances in diagnosis and treatment, candidaemia is one of the major cause of morbidity and mortality in healthcare facility. The changing antifungal spectrum of Candida blood stream infection has generated great concern about the emergence of drug resistance strains of azole and its clinical outcome. The aim of the study is to speciate and determine the antifungal susceptibility testing of candida species isolated from bloodstream infection by use of VITEK 2 system. MATERIALS AND METHODS In a prospective study, a total of 50 Candida species isolated from bloodstream infection were subjected to identification and antifungal susceptibility testing by VITEK 2 automated system. RESULTS Among the 50 Candida blood isolates, C. tropicalis was the predominant strain isolated in 22 (44%) isolates, followed by C. albicans in 15 (30%), C. glabrata in 7 (14%), C. krusei in 3 (6%), C. parapsilosis in 2 (4%) and C. kefyr in 1 (2%) isolate. All the C. albicans showed 100% susceptibility to fluconazole, voriconazole, flucytosine and amphotericin B. C. glabrata showed 100% resistance to azoles. C. krusei showed 100% resistance to fluconazole. A 4.5% C. tropicalis showed resistance to amphotericin B. CONCLUSION The successful treatment of Candida infections in blood depends on the rapid identification of the species and sensitivity patterns to antifungal agents. VITEK 2 system is a valuable tool for identification and AST as it is rapid and less cumbersome. Amphotericin B and voriconazole seem to be suitable drugs for empirical therapy in severe cases and fluconazole is not suitable because most of the Candida species are resistance to them