PREVALENCE AND ANTIFUNGAL SUSCEPTIBILITY OF CANDIDA SPECIES IN BLOODSTREAM INFECTIONS AMONG PEDIATRIC PATIENTS IN A TERTIARY CARE HOSPITAL

Introduction: Candidemia, a severe and potentially life-threatening bloodstream infection caused by Candida species, remains a significant concern in pediatric populations, especially in developing countries such as India. The increasing prevalence of non-albicans Candida (NAC) species, which often exhibit reduced susceptibility to commonly used antifungal agents, has further complicated clinical management and therapeutic outcomes. Aim: The present study aimed to evaluate the prevalence of Candida species in bloodstream infections among pediatric patients and to characterize their antifungal resistance patterns. Material and methods: Blood samples from patients with suspected candidemia were collected in automated blood culture bottles. Identification of Candida species was performed using standard microbiological techniques, including the VITEK 2 Compact system. Antifungal susceptibility was assessed using the AST-YS09 card, which determines the minimum inhibitory concentration (MIC) for six antifungal agents i.e., voriconazole, caspofungin, flucytosine, micafungin, fluconazole, and amphotericin B. Results: A total of 97 (6.2%) Candida isolates were identified, with Candida albicans (32%) being the most prevalent species, followed by Candida tropicalis (22.6%), Candida parapsilosis (19.5%), Candida pelliculosa (12.3%), Candida glabrata (7.2%), Candida krusei (4.1%), and Candida guilliermondii (2%). Antifungal resistance was notable, with 36% of isolates resistant to flucytosine, 32% to fluconazole, 26% to amphotericin B, 21.6% to voriconazole, 14.4% to micafungin and 12.3% to caspofungin. Conclusion: Our study highlights a higher incidence of non-albicans Candida species compared to Candida albicans, with a notable resistance to various antifungal agents. These findings underscore the urgent need for antifungal stewardship programs and stringent preventive control measures to mitigate the further spread of antifungal resistance.