A six-year hospital-based surveillance study on burden of esophageal candidiasis in Gangtok, Sikkim

Background and Objectives: Esophageal candidiasis once thought to be restricted amongst immunocompromised patients is being increasingly reported among non-immunocompromised individuals. It is debilitating and if not treated well may cause chronic long-lasting infections. The objective of this stud...

Full description

Bibliographic Details
Main Authors: Shrijana Gurung, Tara Devi Sharma, Suresh Madan Rasaily, Raju Singh, Peralam Yegneswaran Prakash
Format: Article
Language:English
Published: Tehran University of Medical Sciences 2022-08-01
Series:Iranian Journal of Microbiology
Subjects:
Online Access:https://ijm.tums.ac.ir/index.php/ijm/article/view/3038
_version_ 1798041981951148032
author Shrijana Gurung
Tara Devi Sharma
Suresh Madan Rasaily
Raju Singh
Peralam Yegneswaran Prakash
author_facet Shrijana Gurung
Tara Devi Sharma
Suresh Madan Rasaily
Raju Singh
Peralam Yegneswaran Prakash
author_sort Shrijana Gurung
collection DOAJ
description Background and Objectives: Esophageal candidiasis once thought to be restricted amongst immunocompromised patients is being increasingly reported among non-immunocompromised individuals. It is debilitating and if not treated well may cause chronic long-lasting infections. The objective of this study was to identify the various species of Candida causing esophageal candidiasis and analyse their antifungal susceptibility pattern. Materials and Methods: This was an observational, prospective study. Total of 108 patients who attended the Gastroenterology Department of Sir Thutob Namgyal Memorial Hospital, Govt of Sikkim, Gangtok, India between July 2012 – May 2018 were included in the study. They had complaints of upper gastrointestinal disturbances and chronic dyspeptic symptoms that required an endoscopy. Esophageal biopsy and brushings were taken and were transported to Microbiology Department. They were subjected to microscopic observation, fungal culture on Sabourauds dextrose agar. Preliminary species identification was done by chlamydospore formation and growth characteristics on CHROMagar Candida. Species confirmation and antifungal susceptibility testing was done on VITEK 2 system at Microbiology Department, Kasturba Medical College and Hospital, MAHE, Manipal, Karnataka, India. Results: A total of 108 patients were screened among which 73 samples were positive for Candida species and species identification and antifungal susceptibility was performed. Forty fiveisolates were found to be C. albicans, 8 were C. glabrata, 4 were C. tropicalis, 3 were C. lusitaniae 2 were C. krusei, 2 were C. lipolyticaand 1 was C. parapsilosis. Eight isolates could not be identified and were recorded as Candida spp. C. albicans isolates were predominantly sensitive strain with susceptibility of 95% for both amphotericin B and fluconazole and 100% for caspofungin. C. glabrata showed high resistance to fluconazole with one isolate showing intermediate resistance to caspofungin. Conclusion: Upper gastrointestinal symptoms even in non-immunocompromised patients need to be screened by endoscopy to rule out esophageal candidiasis. With the emergence of drug resistant non albicans Candida species diagnostic testing laboratories should include Candida species identification and antifungal susceptibility testing facility to provide effective patient care.
first_indexed 2024-04-11T22:30:09Z
format Article
id doaj.art-48cd4103a3e04ea49448346904855cd7
institution Directory Open Access Journal
issn 2008-3289
2008-4447
language English
last_indexed 2024-04-11T22:30:09Z
publishDate 2022-08-01
publisher Tehran University of Medical Sciences
record_format Article
series Iranian Journal of Microbiology
spelling doaj.art-48cd4103a3e04ea49448346904855cd72022-12-22T03:59:31ZengTehran University of Medical SciencesIranian Journal of Microbiology2008-32892008-44472022-08-0114410.18502/ijm.v14i4.10247A six-year hospital-based surveillance study on burden of esophageal candidiasis in Gangtok, SikkimShrijana Gurung0Tara Devi Sharma1Suresh Madan Rasaily2Raju Singh3Peralam Yegneswaran Prakash4Department of Microbiology, Sir Thutob Namgyal Memorial Hospital, Gangtok, Sikkim, IndiaDepartment of Microbiology, Sir Thutob Namgyal Memorial Hospital, Gangtok, Sikkim, IndiaDepartment of Gastroenterology, Sir Thutob Namgyal Memorial Hospital, Gangtok, Sikkim, IndiaHealth & Family Welfare Department, Community Health Centre, Rhenock Hospital, East Sikkim, IndiaDepartment of Microbiology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India Background and Objectives: Esophageal candidiasis once thought to be restricted amongst immunocompromised patients is being increasingly reported among non-immunocompromised individuals. It is debilitating and if not treated well may cause chronic long-lasting infections. The objective of this study was to identify the various species of Candida causing esophageal candidiasis and analyse their antifungal susceptibility pattern. Materials and Methods: This was an observational, prospective study. Total of 108 patients who attended the Gastroenterology Department of Sir Thutob Namgyal Memorial Hospital, Govt of Sikkim, Gangtok, India between July 2012 – May 2018 were included in the study. They had complaints of upper gastrointestinal disturbances and chronic dyspeptic symptoms that required an endoscopy. Esophageal biopsy and brushings were taken and were transported to Microbiology Department. They were subjected to microscopic observation, fungal culture on Sabourauds dextrose agar. Preliminary species identification was done by chlamydospore formation and growth characteristics on CHROMagar Candida. Species confirmation and antifungal susceptibility testing was done on VITEK 2 system at Microbiology Department, Kasturba Medical College and Hospital, MAHE, Manipal, Karnataka, India. Results: A total of 108 patients were screened among which 73 samples were positive for Candida species and species identification and antifungal susceptibility was performed. Forty fiveisolates were found to be C. albicans, 8 were C. glabrata, 4 were C. tropicalis, 3 were C. lusitaniae 2 were C. krusei, 2 were C. lipolyticaand 1 was C. parapsilosis. Eight isolates could not be identified and were recorded as Candida spp. C. albicans isolates were predominantly sensitive strain with susceptibility of 95% for both amphotericin B and fluconazole and 100% for caspofungin. C. glabrata showed high resistance to fluconazole with one isolate showing intermediate resistance to caspofungin. Conclusion: Upper gastrointestinal symptoms even in non-immunocompromised patients need to be screened by endoscopy to rule out esophageal candidiasis. With the emergence of drug resistant non albicans Candida species diagnostic testing laboratories should include Candida species identification and antifungal susceptibility testing facility to provide effective patient care. https://ijm.tums.ac.ir/index.php/ijm/article/view/3038Candida;Candidiasis;Esophagitis;Antifungal;Endoscopy;Amphotericin B;
spellingShingle Shrijana Gurung
Tara Devi Sharma
Suresh Madan Rasaily
Raju Singh
Peralam Yegneswaran Prakash
A six-year hospital-based surveillance study on burden of esophageal candidiasis in Gangtok, Sikkim
Iranian Journal of Microbiology
Candida;
Candidiasis;
Esophagitis;
Antifungal;
Endoscopy;
Amphotericin B;
title A six-year hospital-based surveillance study on burden of esophageal candidiasis in Gangtok, Sikkim
title_full A six-year hospital-based surveillance study on burden of esophageal candidiasis in Gangtok, Sikkim
title_fullStr A six-year hospital-based surveillance study on burden of esophageal candidiasis in Gangtok, Sikkim
title_full_unstemmed A six-year hospital-based surveillance study on burden of esophageal candidiasis in Gangtok, Sikkim
title_short A six-year hospital-based surveillance study on burden of esophageal candidiasis in Gangtok, Sikkim
title_sort six year hospital based surveillance study on burden of esophageal candidiasis in gangtok sikkim
topic Candida;
Candidiasis;
Esophagitis;
Antifungal;
Endoscopy;
Amphotericin B;
url https://ijm.tums.ac.ir/index.php/ijm/article/view/3038
work_keys_str_mv AT shrijanagurung asixyearhospitalbasedsurveillancestudyonburdenofesophagealcandidiasisingangtoksikkim
AT taradevisharma asixyearhospitalbasedsurveillancestudyonburdenofesophagealcandidiasisingangtoksikkim
AT sureshmadanrasaily asixyearhospitalbasedsurveillancestudyonburdenofesophagealcandidiasisingangtoksikkim
AT rajusingh asixyearhospitalbasedsurveillancestudyonburdenofesophagealcandidiasisingangtoksikkim
AT peralamyegneswaranprakash asixyearhospitalbasedsurveillancestudyonburdenofesophagealcandidiasisingangtoksikkim
AT shrijanagurung sixyearhospitalbasedsurveillancestudyonburdenofesophagealcandidiasisingangtoksikkim
AT taradevisharma sixyearhospitalbasedsurveillancestudyonburdenofesophagealcandidiasisingangtoksikkim
AT sureshmadanrasaily sixyearhospitalbasedsurveillancestudyonburdenofesophagealcandidiasisingangtoksikkim
AT rajusingh sixyearhospitalbasedsurveillancestudyonburdenofesophagealcandidiasisingangtoksikkim
AT peralamyegneswaranprakash sixyearhospitalbasedsurveillancestudyonburdenofesophagealcandidiasisingangtoksikkim