Abstract
POSTER SESSION 1, SEPTEMBER 21, 2022, 12:30 PM - 1:30 PM: OBJECTIVES: Primary Objectives: 1. To perform the phenotypic identification of the Candida isolates. 2. To perform genotypic identification for confirmation of the Candida species. 3. To prepare antifungal susceptibility profiles of each Candida isolate. Secondary Objectives: 1. To determine the clinical spectrum. 2. To stratify patients based on clinical risk such as per parameters as prior hospitalization and risk for invasive fungal infections. METHODS: Cross-sectional hospital-based study of 1-year duration 2020-2021. All samples sent to the microbiology laboratory with clinical suspicion of Candida infection and fulfilling the inclusion criteria were considered as sample size for the study period. The study population was the clinically relevant Candida isolates for which antifungal susceptibility testing was done and fulfilling the inclusion criteria. Study duration was for 1-year and was held at AIIMS, Bhopal. The data collected was entered in MS EXCEL and latest WHONET software and analyzed by WHONET software to generate antibiogram for Candida. Results are summarized in percentages and frequencies. RESULTS: Total 110 Candida isolates were included in the study for antifungal susceptibility testing and WHONET entry after fulfilling the inclusion criteria. The commonest isolate across all samples processed and included was C. tropicalis 40% followed by C. glabrata 15.5%. A total of 43.6% Candida species were isolated from urine samples followed by 29% from blood samples and 10% from sputum samples. In all 54.5% of yeast isolates were from ICU followed by 40% from ward patients and at least 5.45% from OPD. The commonest isolate across all locations was C. tropicalis 40% followed by C. glabrata 15.5%, C. albicans 14.5% and C. parapsilosis 11.8%. The predominant isolates were under the age category 19-60 years, 69% followed by 26.4% >60 years of age. The percentage susceptibility of C. tropicalis isolates showed >90% susceptibility to tested antifungals. The percentage susceptibility of C. glabrata isolates showed susceptibility to echinocandin but reduced susceptibility to fluconazole. For Candida albicans overall no azole or echinocandin resistance was noted. For Candida parapsilosis overall no azole or echinocandin resistance was noted. C. krusei showed 100% susceptibility to anidulafungin, caspofungin, micafungin, and voriconazole by BMD. C. guilliermondii percentage susceptibility available for caspofungin 33.3%. A total of 80% of the isolates were from patients with community-acquired infections and 19% Candida species were from health care-associated infections. Among the community-acquired infections C. tropicalis was the commonest 37.5% followed by C. albicans 17%, C. glabrata 16%, and C. parapsilosis 12.5%. Among the HAI commonest isolate was C. tropicalis 47.6% followed by 14.3% each of C. auris, and C. glabrata. C. auris all isolates showed elevated MIC fluconazole(≥64 μg/ml), voriconazole (≥1 μg/ml), and caspofungin (≥1 μg/ml). CONCLUSION: The study conducted just over a year period in the department of microbiology of AIIMS Bhopal has been instrumental in generating cumulative antifungal antibiogram for Candida species.