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Characterization and susceptibility of non-albicans Candida isolated from various clinical specimens in Lebanese
Rola Husni1,2, Maroun Bou Zerdan3, Nadia Samaha4
1Lebanese American University, School of Medicine, Beirut, Lebanon.
Background:
Invasive fungal infections have presented a challenge in treatment. In the past, it was known that the frontrunner in such infections is Candida albicans with little emphasis placed on non-albicans Candida species (NAC). Studies worldwide have shown a rise in fungal infections attributed to non-albicans Candida species. The aim of this study is to describe the epidemiology of NAC infections along with an overview of resistance in Lebanese hospitals.
Methods:
This is a two-year observational multi-central descriptive study. Between September 2016 and May of 2018, a total of 1000 isolates were collected from 10 different hospitals distributed all over the country. For the culture, Sabouraud Dextrose Agar was used. Antifungal Susceptibility was evaluated by determining the Minimum Inhibitory Concentration (MIC) in broth (microdilution) of the different antifungal treatments.
Results:
Out of the 1000 collected isolates, Candida glabrata, being the most isolated species (40.8%), followed by Candida tropicalis: 231(23.1%), Candida parapsilosis: 103(10.3%), and other NAC species at lower percentage. Most of these isolates (88.67%) were susceptible to posaconazole, 98.22% were susceptible to micafungin, and 10% were susceptible to caspofungin.
Conclusion:
The change of etiology of fungal infections involving a significant increase in NAC cases is alarming due to the different antifungal susceptibility patterns and the lack of local guidelines to guide the treatment. In this context, proper identification of such organisms is of utmost importance. The data presented here can help in establishing guidelines for the treatment of candida infections to decrease morbidity and mortality. Future surveillance data are needed.
Insights
Non-albicans Candida (NAC) species are increasingly causing fungal infections, posing treatment challenges. This study highlights NAC epidemiology and antifungal resistance in Lebanese hospitals, emphasizing the need for updated treatment guidelines.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Epidemiology
Background:
- Invasive fungal infections (IFIs) are a significant clinical challenge.
- Candida albicans has historically dominated IFIs, with less focus on non-albicans Candida (NAC) species.
- Recent global trends indicate a rise in IFIs caused by NAC species.
Purpose of the Study:
- To investigate the epidemiology of non-albicans Candida infections in Lebanese hospitals.
- To assess the antifungal resistance patterns of NAC species within the Lebanese healthcare system.
- To provide data for the development of local treatment guidelines for Candida infections.
Main Methods:
- A two-year observational, multi-central descriptive study was conducted from September 2016 to May 2018.
- A total of 1000 Candida isolates were collected from 10 hospitals across Lebanon.
- Antifungal susceptibility testing was performed using broth microdilution to determine Minimum Inhibitory Concentrations (MICs).
Main Results:
- Non-albicans Candida species constituted a significant proportion of isolates, with Candida glabrata being the most prevalent (40.8%).
- Other common NAC species included Candida tropicalis (23.1%) and Candida parapsilosis (10.3%).
- High susceptibility rates were observed for posaconazole (88.67%) and micafungin (98.22%), while susceptibility to caspofungin was lower (10%).
Conclusions:
- The increasing prevalence of NAC infections necessitates a shift in clinical focus and treatment strategies.
- Varied antifungal susceptibility patterns among NAC species underscore the importance of accurate species identification.
- The findings support the need for evidence-based local guidelines to effectively manage Candida infections and reduce patient morbidity and mortality.
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