Prevalence of Invasive candidiasis in Blood stream infection in ICU patients of A Multi-Speciality Hospital, Gujarat

Introduction: Invasive candidiasis is a fungal disease caused by Candida spp. that affects internal organs through blood stream infections. It’s a major concern in hospitals, accounting for 96% of opportunistic mycoses. Candida infections occur due to interplay between fungal virulence and host immune responses. India’s estimated annual incidence of candidemia is 4,70,000 cases, with Candida tropicalis, Candida albicans, and Candida auris being major contributors. Methodology: A laboratory based retrospective analytic study was conducted over period 2-year (May 2022 – April 2024). The blood culture bottles were processed in Microbiology Laboratory, using BACT/ALERT 3D machine for 5-day aerobic incubation, identification of Candida spp was done by Gram stain, culture on SDA, Germ tube test and subspecies conformation Candida Chromogenic media used, further identification and antifungal susceptibility testing was done by VITEK 2 COMPACT. Result: 2213 blood cultures were collected from suspected sepsis patients in ICUs. Out of these, 970 (43%) were positive and among them Candida spp. was isolated in 76 (7.8%). Out of these 76 (7.8%) specimens, isolation rate of Candida albicans was 17% while 83% being Candida non-albicans. Among Candida albicans, we found that, resistance rate to fluconazole was 23% while with voriconazole its 46%. Among Candida non-albican highest resistance was seen with fluconazole whereas Flucytosine, Capsofungin, and Micafungin showed highest sensitivity. Conclusion: The study found that prevalence of candidemia was 7.8%. Isolation rate of Candida non albicans was higher as compared to Candida albicans. Candida albicans and non albicans showed highest resistance to azole group, but sensitive to echinocandins group. Accurate identification of Candida species and their antifungal resistance is crucial for early intervention, personalized treatment, and improved patient outcomes.