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Challenges in Identifying Uncommon Clinical Isolates of Candida Species Using Conventional Phenotypic Methods: A Clinical Concern

Summary

This study examined different methods for identifying Candida fungi in patient samples from a hospital in rural India. Researchers found that a dangerous fungus called Candida auris was being misidentified by traditional laboratory methods, while a newer automated system identified it correctly. The study also showed that many Candida infections are becoming resistant to common antifungal drugs, highlighting the need for better identification methods and careful drug selection.

Background

Candida species, particularly non-albicans Candida species, have emerged as major causes of human infection with multidrug resistance. Accurate speciation is crucial for effective treatment, yet many mycology laboratories still rely on conventional phenotypic methods despite known misidentification issues.

Objective

To compare various Candida speciation methods including conventional phenotypic methods, chromogenic media, and the VITEK 2 compact system, and to assess antifungal susceptibility patterns of clinical isolates at a rural tertiary care hospital.

Results

Among 78 isolates, seven were C. albicans while 71 were non-albicans species including C. tropicalis (53), C. parapsilosis (15), C. auris (2), and C. glabrata (1). Neither conventional nor chromogenic methods accurately identified C. auris. High resistance rates were observed for fluconazole (57.7%), itraconazole (66.7%), and voriconazole (60.3%).

Conclusion

The study highlights the increasing prevalence of non-albicans Candida species with high multidrug resistance in rural India. Conventional phenotypic methods and chromogenic media failed to accurately identify C. auris, emphasizing the need for automated identification systems like VITEK 2 for reliable species identification, particularly for emerging and phenotypically similar species.
  • Published in:Cureus,
  • Study Type:Prospective Cross-sectional Study,
  • Source: 41234976
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