INCREASING TREND IN NON ALBICANS CUTANEOUS CANDIDIASIS: IMPLICATIONS IN TREATMENT STRATEGIESR. BHARATHI, ASHA B. PATIL AND SHOBHA MEDGAR
To speciate the Candida isolated from suspected cases of cutaneous candidiasis and find out the antifungal susceptibility for voriconazole and fluconazole among the isolates. Two hundred patients were included in the study who presented with the symptoms of cutaneous candidiasis to the Dermatology OPD, KIMS, HUBLI. Skin scrapings, skin swabs, nail clippings were the samples obtained according to the lesion presented from 200 patients. The samples were subjected to Gram stain and KOH mount. Samples were cultured on Sabourauds dextrose agar (HiMedia) and incubated at 370 C. The isolates were identified as Candida by Gram stain. Candida isolates were further speciated by germ tube test, chlamydospore production and morphology on cornmeal agar, colored colonies on HiCrome Candida differential agar, Sugar assimilation on Yeast Nitrogen Base (YNB agar). Antifungal susceptibility testing was done on MHA by disk diffusion method.Intertrigo39 (48.75%) was the most common type of candidiasis, followed by onychomycosis 29 (36.25%) and napkin rash 12 (15%). Amongthe isolates NAC accounted for 56 (70%). Overall resistance to fluconazole was 14 (17.50%), least resistance was observed among C.albicans ie., 2(9.09%) and highest among C.krusei i.e., 6 (100%). The rise in the incidence of non albicans candida compared to Candida albicans in cutaneous candidiasis is significant. The emergence of NAC species is of concern as they are known to be resistant to routinely prescribed antifungals. Antifungal susceptibility following speciation helps in the prevention of treatment failures and morbidity.
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