Title: Characterization and Biofilm Detection of Candida Species in a Tertiary Care Hospital
Authors: Dr Rameez Raja, Dr Beena
DOI: https://dx.doi.org/10.18535/jmscr/v7i12.108
Abstract
Introduction
Fungal diseases came into clinical importance in the second half of last century. In the past 20 years, the advent of the AIDS epidemic and advances in medical field has even further opened up the clinical mycology field. One of the most frequent opportunistic pathogens among the fungi is the Candida species.
Candida species are ubiquitous yeasts, found as normal commensals on human body surfaces and the gastrointestinal tract. The frequency of Candida infection has increased due to the use of broad-spectrum antibiotics, corticosteroids, immunosuppressive agents, use of invasive medical devices in health care, malignancy etc.
The clinical spectrum of infections caused by them varies from acute or chronic, superficial or deep, localized or systemic. They are recognised as one of the major causes of hospital acquired infections. Although there are about 200 species of Candida, it is well established that only small number are human pathogens. The recent studies suggest that with the introduction of Fluconazole and Itraconazole, there is an increased prevalence of Non-albicans species. Infections with Candida tropicalis, Candida glabrata, Candida krusei and other Candida species are emerging as important opportunistic pathogens. This transition has had a significant clinical impact due to decreased susceptibility of these Non-albicans yeasts to antifungal agents.
Candidastrains possess a number of virulence factors which enable them to spread hematogenously in susceptible hosts and also aid in persistence and colonization of the host tissue. One of the most important factors is the ability to produce biofilms. A significant proportion of Candida species (73%) produce biofilms.(1) Biofilm provides protection from environment, increases nutrient availability, metabolic cooperation and acquisition of new genetic traits for the organisms and thus enhanced drug resistance.
In this study, we have isolated the Candida species from different clinical samples. Speciation, antifungal susceptibility pattern and the ability of these isolates to produce biofilm was determined.
References
- Mohandas V, Ballal M. Distribution of Candida Species in Different Clinical Samples and Their Virulence: Biofilm Formation, Proteinase and Phospholipase Production: A Study on Hospitalized Patients in Southern India. J Glob Infect Dis. 2011;3(1):4–8.
- Candidiasis Ch 20 In Jagdish Chander Textbook of Medical Mycology, Mehta publishers, New Delhi, 3rd edition, 2010,266-283.
- Hospenthal DR, Beckius ML, Floyd KL, Horvath LL, Murray CK. Presumptive identification of Candida species other than C. albicans, C. krusei, and C. tropicalis with the chromogenic medium CHROM agar Candida. Ann Clin Microbiol Antimicrob. 2006 Jan 3;5(1):1.
- WHO, Laboratory manual for diagnosis of fungal opportunistic infections in HIV/AIDS patients; 201
- Christensen GD, Simpson WA, Bisno AL, Beachey EH. Adherence of slime-producing strains of Staphylococcus epidermidis to smooth surfaces. Infect Immun. 1982 Jul;37(1):318–26.
- Clinical and Laboratory Standards Institute. 2009. Method for antifungal disk diffusion susceptibility testing of yeasts; approved guideline, 2nd ed., M44-A2. Clinical and Laboratory Standards Institute, Wayne, PA.
- Crump JA, Collignon PJ. Intravascular catheter-associated infections. Eur J Clin Microbiol Infect Dis Off Publ Eur Soc Clin Microbiol. 2000 Jan;19(1):1–8.
- Dag I, Kiraz N, Oz Y. Evaluation of different detection methods of biofilm formation in clinical Candida isolates. Afr J Microbiol Res. 2010 Dec 18;4(24):2763–8.
- Vijaya D., Harsha T.R., Nagaratnamma T. “Candida Speciation Using Chrom Agar” Journal of Clinical and Diagnostic Research. 2011; 5(4): 755-757.
- De Luca C, Guglielminetti M, Ferrario A, Calabr M, Casari E. Candidemia: species involved, virulence factors and antimycotic susceptibility. New Microbiol. 2012 Oct;35(4):459–68.