EMERGENCE OF NON-ALBICANS CANDIDA AND USE OF CHROMAGAR FOR SPECIATION OF CANDIDA IN A RESOURCE-LIMITED SETTING

SHEFALI GARG; ANURADHA MALHOTRA; LOVEENA OBEROI; SAPNA BATRA; KAMALDEEP SINGH

doi:10.22159/ajpcr.2024v17i8.51488

Authors

SHEFALI GARG Department of Microbiology, Government Medical College, Amritsar, Punjab, India. https://orcid.org/0009-0007-0911-4185
ANURADHA MALHOTRA Department of Microbiology, Government Medical College, Amritsar, Punjab, India. https://orcid.org/0000-0003-4850-9140
LOVEENA OBEROI Department of Microbiology, Government Medical College, Amritsar, Punjab, India.
SAPNA BATRA Department of Microbiology, Government Medical College, Amritsar, Punjab, India. https://orcid.org/0000-0003-0372-2124
KAMALDEEP SINGH Department of Microbiology, Government Medical College, Amritsar, Punjab, India.

DOI:

https://doi.org/10.22159/ajpcr.2024v17i8.51488

Keywords:

Non-albicans Candida, CHROMagar,, Candida albicans

Abstract

Objective: Candida infections, especially those caused by non-albicans Candida species, have become increasingly common in recent years. These species’ early isolation and identification are essential for their effective management. This study aimed to evaluate the efficacy of CHROMagar for the speciation of Candida.

Methods: All clinical samples received in the microbiology laboratory from April 2023 to March 2024 were processed as per microbiological criteria. The isolates that revealed Gram-positive budding yeast cells on Gram staining were further identified and speciated using CHROM agar and conventional methods.

Results: A total of 749 Candida were isolated from various clinical samples. Candida albicans was the most common species isolated (46.41%), followed by Candida glabrata (23.63%), Candida krusei (14.15%), Candida parapsilosis (9.2%), and Candida tropicalis (6.5%) while sensitivity and specificity of CHROM agar were 100% for C. glabrata and C. krusei and 98.3% and 100% for C. albicans while 100% sensitivity and 94.2%, 96% specificity for C. parapsilosis and C. tropicalis, respectively, when compared to conventional methods.

Conclusion: CHROM agar’s performance was nearly identical to that of conventional methods. Compared to time-consuming, technically complex, and costly conventional methods, using this medium is quick, easy to use, and economical.

Downloads

Download data is not yet available.

References

Shwetha DC, Venkatesha D Speciation of Candida using CHROMagar isolated from various clinical samples. Trop J Pathol Microbiol.

Apr 30;6(4):303-8. doi: 10.17511/jopm.2020.i04.06

Kaur P, Rawat T, Sharma S, Kaur P. Speciation of Candida species isolated in clinical samples in a tertiary health care centre in Northern India. IP Int J Med Microbiol Trop Dis. 2021;7(4):262-8. doi: 10.18231/j.ijmmtd.2021.054

Jaggi T, Urhekar AD, Pai C. Study of Candida species in various clinical samples in a tertiary care hospital. DHR Int J Med Sci. 2014;5:83-8.

Deorukhkar SC, Saini S, Mathew S. Non-albicans Candida infection: An emerging threat. Interdiscip Perspect Infect Dis. 2014 Oct 22;2014:7 .doi: 10.1155/2014/615958, PMID 25404942

Seyoum E, Bitew A, Mihret A. Distribution of Candida albicans and non-albicans Candida species isolated in different clinical samples and their in vitro antifungal suscetibity profile in Ethiopia. BMC Infect Dis. 2020 Mar 19;20(1):231. doi: 10.1186/s12879-020-4883-5, PMID32188422

Colombo AL, Nucci M, Park BJ, Nouér SA, Arthington-Skaggs B, Da Matta DA, et al. Epidemiology of candidemia in Brazil: A nationwide sentinel surveillance of candidemia in eleven medical centers. J Clin Microbiol. 2006 Aug;44(8):2816-23. doi: 10.1128/JCM.00773-06, PMID 16891497

Nadeem SG, Hakim ST, Kazmi SU. Use of CHROMagar Candida for the presumptive identification of Candida species directly from clinical specimens in resource-limited settings. Libyan J Med. 2010 Feb 9;5. doi: 10.3402/ljm.v5i0.2144, PMID 21483597

Nazir A, Kanth F. Identification and speciation of Candida isolates using CHROM agar-a hospital based study. Int J Health Sci Res.

Mar;6(3):80-6. ed. New Delhi: Mehta Publishers; 2018. p. 266-9.

Chander J. Textbook of Medical Mycology. 3rd

Mokaddas EM, Al-Sweih NA, Khan ZU. Species distribution and antifungal susceptibility of Candida bloodstream isolates in Kuwait:

A 10-year study. J Med Microbiol. 2007 Feb;56(Pt 2):255-9. doi:10.1099/jmm.0.46817-0, PMID 17244809

Toure OA, Bonouma-Ira A, Angora E, Vanga BH, Sylla K, Ako AB, et al. Species identification of Candida isolates in various clinical

specimens and their antifungal susceptibility patterns in CÃ´te dâ€™Ivoire. Afr J Microbiol Res. 2016 Jan 14;10(2):66-72. doi:

5897/AJMR2015.7834

Hospenthal DR, Murray CK, Rinaldi MG. The role of antifungal susceptibility testing in the therapy of candidiasis. Diagn Microbiol Infect Dis. 2004 Mar;48(3):153-60. doi: 10.1016/j.diagmicrobio.2003.10.003,

PMID 15023422

Istalingam GI, Dillirani V, Rathinam S. Isolation and speciation of Candida from various clinical samples by using conventional method and chrom agar in a tertiary care centre. MedPulse Int J Microbiol. 2021;20(1):10.

Maertens JA. History of the development of azole derivatives. Clin Microbiol Infect. 2004 Mar;10 Suppl 1:1-10. doi: 10.1111/j.14709465.2004.00841.x, PMID 14748798

Collee JG, Fraser AG, Marmion BP, Simmons A. Mackie and McCartney Practical Medical Microbiology. 14

ed. United Kingdom: Churchill Livingstone; 2011.th

Devadas SM, Ballal M, Prakash PY, Hande MH, Bhat GV, Mohandas V. Auxanographic carbohydrate assimilation method for large scale yeast identification. J Clin Diagn Res. 2017 Apr;11(4):DC01-3. doi: 10.7860/ JCDR/2017/25967.9653, PMID 28571137

Bharathi R. Comparison of chromogenic media with the corn meal agar for speciation of Candida. J Pure Appl Microbiol. 2018;12(3):1617-22. doi: 10.22207/JPAM.12.3.68

Kanna BV, Kumar GA, Swapna M, Easow JM. Isolation and identification of Candida species from various clinical samples in a

tertiary care hospital. Int J Res Med Sci. 2017 Jul 26;5(8):3520-2. doi: 10.18203/2320-6012.ijrms20173554

Chakrabarti A, Mohan B, Shrivastava SK, Marak RS, Ghosh A, Ray P. Change in distribution and antifungal susceptibility of Candida species isolated from candidaemia cases in a tertiary care centre during 19962000. Indian J Med Res. 2002

Jul;116:5-12. PMID 12514972

Pfaller MA, Pappas PG, Wingard JR. Invasive fungal pathogens:Current epidemiological trends. Clin Infect Dis. 2006 Aug 1;43

(Suppl 1):S3-14. doi: 10.1086/504490

Bourgeois N, Dehandschoewercker L, Bertout S, Bousquet PJ, Rispail P, Lachaud L. Antifungal susceptibility of 205 Candida spp. Isolated primarily during invasive candidiasis and comparison of the Vitek 2 system with the CLSI broth microdilution and Etest methods. J Clin Microbiol. 2010 Jan;48(1):154-61. doi: 10.1128/JCM.01096-09, PMID19889902

Willinger B, Manafi M. Evaluation of CHROMagar Candida for rapid screening of clinical specimens for Candida species. Mycoses.

Apr;42(1-2):61-5. doi: 10.1046/j.1439-0507.1999.00406.x, PMID 10394850

PMID 10394850

Manjunath V, Vidya GS, Sharma A, Prakash MR, Murugesh. Speciation of Candida by Hicrome agar and sugar assimilation test

in both HIV infected and non-infected patients. Int J Biol Med Res. 2012 Jan 1;3(2):1778-82.

Anita, Kumar S, Pandya HB. Speciation and antifungal susceptibility testing of Candida isolated from immunocompromised patients

of a Tertiary care centre in Gujarat, India. J Pure Appl Microbiol. 2023;17(1):427-33. doi: 10.22207/JPAM.17.1.34

Agarwal S, Manchanda V, Verma N, Bhalla P. Yeast identification in routine clinical microbiology laboratory and its clinical relevance.

Indian J Med Microbiol. 2011;29(2):172-7. doi: 10.4103/0255-0857.81794, PMID 21654115

Mulu A, Kassu A, Anagaw B, Moges B, Gelaw A, Alemayehu M, et al. Frequent detection of ‘azole’ resistant Candida species among late presenting AIDS patients in northwest Ethiopia. BMC Infect Dis. 2013 Feb 12;13(1):82. doi: 10.1186/1471-2334-13-82, PMID 23398783

ElFeky DS, Gohar NM, El-Seidi EA, Ezzat MM, AboElew SH. Species identification and antifungal susceptibility pattern of Candida isolates in cases of vulvovaginal candidiasis. Alex J Med. 2016 Sep 1;52(3): 269-77.

Jayalakshmi L, RatnaKumari G, Samson SH. Isolation, speciation and antifungal susceptibility testing of Candida from clinical specimens at a tertiary care hospital. Sch J Appl Med Sci. 2014;2(6):3193-8.

Mohan S, Karthikeyan D. Speciation and antifungal susceptibility pattern of Candida isolated from clinical specimens. Int J Curr Microbiol Appl Sci. 2016 Apr 10;5(4):820-4. doi: 10.20546/ijcmas.2016.504.094

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 SouthernIndia. J Glob Infect Dis. 2011;3(1):4-8. doi: 10.4103/0974-777X.77288, PMID 21572601