Emerging threat of candida resistance among neonates at a teaching institute of Jharkhand
Purpose: In the past few decades, candidemia has escalated to worrisome levels, leading to substantial morbidity and mortality in neonates. The rise in anti-fungal drug resistance demands prompt diagnosis and treatment. This study aimed to determine the speciation and susceptibility pattern of Candi...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2023-05-01
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| Series: | Journal of Family Medicine and Primary Care |
| Subjects: | |
| Online Access: | https://journals.lww.com/10.4103/jfmpc.jfmpc_2104_22 |
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| author | Binita Biswas Ashok Kumar Sharma Kumari Seema Abhay Kumar Manju Boipai Manoj Kumar* |
| author_facet | Binita Biswas Ashok Kumar Sharma Kumari Seema Abhay Kumar Manju Boipai Manoj Kumar* |
| author_sort | Binita Biswas |
| collection | DOAJ |
| description | Purpose:
In the past few decades, candidemia has escalated to worrisome levels, leading to substantial morbidity and mortality in neonates. The rise in anti-fungal drug resistance demands prompt diagnosis and treatment. This study aimed to determine the speciation and susceptibility pattern of Candida species recovered from special care new-born units and identify risk factors for developing candidemia in neonates.
Method:
A total of 580 blood samples from clinically suspected septicemic neonates were collected and subjected to culture. Cultures positive for yeasts were sub-cultured on Sabouraud dextrose agar. Identification of a suspected purified colony of Candida was confirmed to the species level by both conventional and automated techniques matrix-assisted laser desorption and ionization time-of-flight mass spectrometry. Anti-fungal susceptibility of isolates was performed by an automated method (VITEK 2 system) using VITEK 2 cards. Multi-variate logistic regression analysis was used to identify risk factors associated with candidemia.
Result:
A total of 56 (9.66%) isolates of Candida species were recovered from 580 blood cultures. Non-albicans Candida species predominated with 82.14% of cases, whereas 17.86% of cases were caused by Candida albicans. Candida tropicalis (46.42%) was the most common isolate recovered, followed by Candida albicans (17.8%). Risk factor analyses identified a very low birth weight [odds ratio (OR) =4.05, 95% confidence interval (CI) =2.03–8.08] and prolonged antibiotic therapy (OR = 3.79, 95% CI = 1.7–8.7) among others as significant predictors of candidemia. All the Candida isolates showed 100% sensitivity to voriconazole and micafungin, whereas the overall sensitivities for fluconazole, amphotericin B, caspofungin, and flucytosine were 85.71%, 96.43%, 96.43%, and 91.07%, respectively.
Conclusion:
Candidemia is a life-threatening condition in neonates. Identification of Candida species and routine anti-fungal susceptibility is a must to select a suitable and effective anti-fungal therapy to revoke emerging resistance to anti-fungals. |
| format | Article |
| id | doaj-art-c99a41b10d67447a98891087fb56a8e0 |
| institution | OA Journals |
| issn | 2249-4863 2278-7135 |
| language | English |
| publishDate | 2023-05-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Family Medicine and Primary Care |
| spelling | doaj-art-c99a41b10d67447a98891087fb56a8e02025-08-20T02:13:43ZengWolters Kluwer Medknow PublicationsJournal of Family Medicine and Primary Care2249-48632278-71352023-05-0112594695210.4103/jfmpc.jfmpc_2104_22Emerging threat of candida resistance among neonates at a teaching institute of JharkhandBinita BiswasAshok Kumar SharmaKumari SeemaAbhay KumarManju BoipaiManoj Kumar*Purpose: In the past few decades, candidemia has escalated to worrisome levels, leading to substantial morbidity and mortality in neonates. The rise in anti-fungal drug resistance demands prompt diagnosis and treatment. This study aimed to determine the speciation and susceptibility pattern of Candida species recovered from special care new-born units and identify risk factors for developing candidemia in neonates. Method: A total of 580 blood samples from clinically suspected septicemic neonates were collected and subjected to culture. Cultures positive for yeasts were sub-cultured on Sabouraud dextrose agar. Identification of a suspected purified colony of Candida was confirmed to the species level by both conventional and automated techniques matrix-assisted laser desorption and ionization time-of-flight mass spectrometry. Anti-fungal susceptibility of isolates was performed by an automated method (VITEK 2 system) using VITEK 2 cards. Multi-variate logistic regression analysis was used to identify risk factors associated with candidemia. Result: A total of 56 (9.66%) isolates of Candida species were recovered from 580 blood cultures. Non-albicans Candida species predominated with 82.14% of cases, whereas 17.86% of cases were caused by Candida albicans. Candida tropicalis (46.42%) was the most common isolate recovered, followed by Candida albicans (17.8%). Risk factor analyses identified a very low birth weight [odds ratio (OR) =4.05, 95% confidence interval (CI) =2.03–8.08] and prolonged antibiotic therapy (OR = 3.79, 95% CI = 1.7–8.7) among others as significant predictors of candidemia. All the Candida isolates showed 100% sensitivity to voriconazole and micafungin, whereas the overall sensitivities for fluconazole, amphotericin B, caspofungin, and flucytosine were 85.71%, 96.43%, 96.43%, and 91.07%, respectively. Conclusion: Candidemia is a life-threatening condition in neonates. Identification of Candida species and routine anti-fungal susceptibility is a must to select a suitable and effective anti-fungal therapy to revoke emerging resistance to anti-fungals.https://journals.lww.com/10.4103/jfmpc.jfmpc_2104_22anti-fungal susceptibility testscandida tropicaliscandidemiavery low birth weight |
| spellingShingle | Binita Biswas Ashok Kumar Sharma Kumari Seema Abhay Kumar Manju Boipai Manoj Kumar* Emerging threat of candida resistance among neonates at a teaching institute of Jharkhand Journal of Family Medicine and Primary Care anti-fungal susceptibility tests candida tropicalis candidemia very low birth weight |
| title | Emerging threat of candida resistance among neonates at a teaching institute of Jharkhand |
| title_full | Emerging threat of candida resistance among neonates at a teaching institute of Jharkhand |
| title_fullStr | Emerging threat of candida resistance among neonates at a teaching institute of Jharkhand |
| title_full_unstemmed | Emerging threat of candida resistance among neonates at a teaching institute of Jharkhand |
| title_short | Emerging threat of candida resistance among neonates at a teaching institute of Jharkhand |
| title_sort | emerging threat of candida resistance among neonates at a teaching institute of jharkhand |
| topic | anti-fungal susceptibility tests candida tropicalis candidemia very low birth weight |
| url | https://journals.lww.com/10.4103/jfmpc.jfmpc_2104_22 |
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