Neonatal Candidaemia in Tertiary Care Hospitals in Dhaka- A Comparison of Different Carbohydrate Assimilation Methods and Chromagar Technique for Speciation

Abstract

Background: Nosocomial candidiasis are becoming increasingly important worldwide. Candida is a major causative agent of health care associated bloodstream infections, and lately non-albican Candida species are increasingly isolated from blood samples. Some of the Candida species have intrinsic and acquired resistance to the limited arsenal of antifungals; therefore early speciation is essential for the timely initiation of effective antifungal therapy. Methods: A hospital based cross-sectional study was conducted to evaluate the performance of different carbohydrate assimilation tests and commercially available HiCrome Candida Differential Media (CHROMagar) for the identification of Candida in the four tertiary level hospitals in Dhaka. Results: A total of 58 yeasts samples was included in this study. Non-albicans Candida accounted for 100% of the isolates of which C. tropicalis was the predominant species (81.03%) followed by C. parapsilosis (12.07%), C. auris (5.17%) and C. dubliniensis (1.72%). Swab auxanographic technique and microtitre plate based miniaturized CHO assimilation methods were equally effective in identification of Candida sp. in comparison to CHO impregnated YNB plate method (98.28% and 100% vs 89.66%). Conclusion: By using Chromogenic agar 75.86% yeasts were identified but it could not give the conclusive differentiating color between the species of C. parapsilosis and C. auris.