Danish Whole-Genome-Sequenced Candida albicans and Candida glabrata Samples Fit into Globally Prevalent Clades

Candida albicans and Candida glabrata are opportunistic fungal pathogens with increasing incidence worldwide and higher-than-expected prevalence in Denmark. We whole-genome sequenced yeast isolates collected from Danish Clinical Microbiology Laboratories to obtain an overview of the Candida population in the country. The majority of the 30 C. albicans isolates were found to belong to three globally prevalent clades, and, with one exception, the remaining isolates were also predicted to cluster with samples from other geographical locations. Similarly, most of the eight C. glabrata isolates were predicted to be prevalent subtypes. Antifungal susceptibility testing proved all C. albicans isolates to be susceptible to both azoles and echinocandins. Two C. glabrata isolates presented azole-resistant phenotypes, yet all were susceptible to echinocandins. There is no indication of causality between population structure and resistance phenotypes for either species.

Frequency of candida infection among intensive care unit patients and their susceptibility profile

species are responsible for causing many health care associated and central line associated infections. They are responsible for causing opportunistic infection in human beings. Genus of is composed of a heterogeneous group of organsims.Invasive infections of mainly caused by , , & . The main objective of this study was to isolates and Non- albicans and their antifungal susceptibility testing.Thestudy was carried out in the Department of Microbiology, in Tmu Hospital Moradabad. Total numbers of 806 clinical samples were processed in which 206 isolates were taken for . Isolation and antifungal susceptibility testing done by Vitek-2 system.Out of 206 samples 77(37%) were and 129(63%) were Non-albicans (NAC). Maximum isolated species were 77(37%), followed by 70(34%), 24(12%), C. glabrata 19(9%), 12(6%), C. krusei 3(1%), C.african 1(1%).Infection caused by NAC species have increased. was the most common isolated species. ,and were shown high susceptibility to fluconazole and voriconazole. Amphotericin B, Caspofungin, Micafungin and Flucytosine shows high susceptibility towards other candida species.

Can We Improve Antifungal Susceptibility Testing?

Systemic antifungal agents are increasingly used for prevention or treatment of invasive fungal infections, whose prognosis remains poor. At the same time, emergence of resistant or even multi-resistant strains is of concern as the antifungal arsenal is limited. Antifungal susceptibility testing (AFST) is therefore of key importance for patient management and antifungal stewardship. Current AFST methods, including reference and commercial types, are based on growth inhibition in the presence of an antifungal, in liquid or solid media. They usually enable Minimal Inhibitory Concentrations (MIC) to be determined with direct clinical application. However, they are limited by a high turnaround time (TAT). Several innovative methods are currently under development to improve AFST. Techniques based on MALDI-TOF are promising with short TAT, but still need extensive clinical validation. Flow cytometry and computed imaging techniques detecting cellular responses to antifungal stress other than growth inhibition are also of interest. Finally, molecular detection of mutations associated with antifungal resistance is an intriguing alternative to standard AFST, already used in routine microbiology labs for detection of azole resistance in Aspergillus and even directly from samples. It is still restricted to known mutations. The development of Next Generation Sequencing (NGS) and whole-genome approaches may overcome this limitation in the near future. While promising approaches are under development, they are not perfect and the ideal AFST technique (user-friendly, reproducible, low-cost, fast and accurate) still needs to be set up routinely in clinical laboratories.

Antifungal Susceptibility Testing: A Primer for Clinicians

Clinicians treating patients with fungal infections may turn to susceptibility testing to obtain information regarding the activity of different antifungals against a specific fungus that has been cultured. These results may then be used to make decisions regarding a patient’s therapy. However, for many fungal species that are capable of causing invasive infections, clinical breakpoints have not been established. Thus, interpretations of susceptible or resistant cannot be provided by clinical laboratories, and this is especially true for many molds capable of causing severe mycoses. The purpose of this review is to provide an overview of susceptibility testing for clinicians, including the methods used to perform these assays, their limitations, how clinical breakpoints are established, and how the results may be put into context in the absence of interpretive criteria. Examples of when susceptibility testing is not warranted are also provided.

PHENOTYPIC CHARACTERIZATION OF CLINICAL ISOLATES OF CANDIDA SPECIES AND ITS SUSCEPTIBILITY TO VARIOUS ANTIFUNGAL AGENTS: A STUDY FROM A TERTIARY CARE HOSPITAL IN WESTERN UTTAR PRADESH

Background: Indiscriminate use of antifungal agents has led to rise in infections caused by Candida species in recent years. Studies on characterization of Candida species followed by antifungal susceptibility testing can be benecial in managing this problem. Objectives: To phenotypically characterize Candida species isolated from various clinical samples and to determine its susceptibility to various antifungal agents. Methods: A total of 119 Candida spp. isolated from various clinical samples were subjected for species identication and antifungal susceptibility testing using an automated Vitek-2 compact system. Results: There was predominance of Non albicans (NAC) species (82.35%) isolated from our Hospital. Candida species were isolated predominantly from blood (68.06%) sample followed by urine (26.05%). C. tropicalis was the predominant NAC species isolated (27.73%) followed by C.krusei, C.guilliermondii (12.61% each), C.parapsilosis (10.08%) and C. glabrata (7.56%). Overall the NAC isolates were resistant to uconazole, voriconazole, caspofungin, micafungin, amphotericin-B, and ucytosine as compared to C. albicans. Conclusion: Predominance of NAC species and emergence of antifungal drug resistance among NAC species is a matter of concern. Thus highlighting that susceptibility should be performed in all cases to achieve good therapeutic results. Strict infection control strategies and a restrictive antifungal policy should be implemented for better clinical outcome.