NEWER CANDIDA SPECIES IN INTENSIVE CARE UNITS OF A TERTIARY CARE TEACHING HOSPITAL AND THEIR MINIMUM INHIBITORY CONCENTRATION

Background: Newer candida species like C. auris, C. duobushaemulonii, C. hemolinni, C. pelliculosa, C. famata, C. lipolytica, C. rugosa and C. utilis are being reported and are known to demonstrate reduced susceptibility to antifungal agents which may either be inherent or acquired. Objective: Materials and Methods: To determine the isolation of newer Candida species from ICU patients with their AFST. A prospective study was conducted for 1 year. 63 non-albicans Candida which were isolated from blood cultures of ICU patients, were speciated using conventional microbiological methods and automated Vitek 2® system. AFST was done on these isolates using broth microdilution method as per CLSI M27- th A3 and 4 edition. Results:C. pelliculosa (10) was the most common, followed by C. auris (8). All the isolates of C. auris had an MIC of >64 μg/ml for uconazole, 5 of them had an MIC of 0.125 μg/ml for ucytosine, 3 had an MIC of 0.25 μg/ml and 0.125 μg/ml for caspofungin and voriconazole respectively, 6 of the isolates had an MIC of 0.0313 μg/ml for posaconazole. The isolates had higher MICs of 8 μg/ml and 16 μg/ml for itraconazole. 4 and 6 C. pelliculosa isolates had an MIC of 0.25 μg/ml for uconazole and ucytosine respectively, MIC of amphotericin B was 0.0625 μg/ml in 4 of those isolates, MICs of 0.015 μg/ml, 0.0313 μg/ml and 0.0625 μg/ml were present in 3 isolates each for caspofungin, 6 and 5 isolates had MIC of 0.0313 μg/ml each for posaconazole and voriconazole. 8 μg/ml was the observed MIC in 3 isolates for itraconazole. Conclusion: In case of Candida species where MIC break points have not been standardized by CLSI, the epidemiological cut offs can be used and treatment can be started.