Diversity, Distribution and Drug Resistant Patterns Of Candida Species Isolated Among Patients Admitted At Tepi General Hospital

Abstract

Candida species are becoming an important cause of opportunistic infections worldwide due to their ability to adapt to various environmental changes. However, in Ethiopia, due to scarcity of data, much has not been documented regarding the diversity and distribution of Candida species. Hospital-based cross sectional study was conducted from September 2022 to June 2023 to investigate the diversity, distribution and drug resistant patterns of Candida species. For the present study 120 admitted patients were selected by using purpusive sampling techniques based on characteristics of infection. Clinical samples including surgical wound swab, blood, oropharengial swab, urine specimens, sputum, stool, and vaginal swabs were collected from patients with signs and symptoms of infections and referred to the study site for culture and susceptibility testing. The results of present study showed that from the total of 120 collected clinical sample, 92/120(76.7%) were positive for Candida infection. Candida prevalence was significantly higher in females than males (P= 0.0254). The most common risk factors was HIV/AIDS which accounts for (90%), followed by pregnancy (86.7%), diabetic mellitus (83.3%), prolonged antibiotic therapy (73.3%) of patients with Candida colonization. A total of 5 species of Candida were identified based on the colony color characteristics on Sabouraud Dextrose Agar, BiGGY agar test and matrix assisted laser desorption/ionization time of flight (MALDI-TOF MS) identification. Among identified 5 Candida species, the predominant Candida species was Candida albicans (55.4%), which was followed by Candida krusei (17.4%) and Candida tropicalis (14.1%), Candida parapsilosis (8.7%) Candida glabrata (4.3%) were the commonest isolates among non albican Candidia species. Of the total of 92 Candida isolates, (71.2%), (7.3%) and (21.5%) Candida isolates were susceptible (affected), susceptible dose dependent (depending on dose and resistant (not affected) to the drug, respectively. Amphotericin-B was the most effective drug. The results showed that, 82.6% (76/92) of the Candida isolates were found to be susceptible to Amphotericin-B. Therefore, Candida species distribution is changing, the emergence of non albicans Candida other than Candida albicans has increased and antifungal drug resistance is also increasing. Eventually, it is recommended that a national surveillance be conducted to study the epidemiology and susceptibility pattern of Candida species isolates to antifungal drugs.