Candida albicans infections in a north Indian tertiary care hospital: Antifungal resistance pattern and role of SDS-PAGE for characterization

With the increase in the number of immunocompromised individuals, there has been a consequent rise in the number of opportunistic infections, especially those due to Candida sp. A rise in the incidence of antifungal resistance has also been reported. The present study was undertaken to evaluate the incidence of C. albicans in superficial and deep-seated infections, to study its antimicrobial susceptibility profile, to analyze the protein-band profile of isolates of C. albicans and assess its use as a means of characterizing the yeast, especially in resistant strains. Seventy-six isolates of C. albicans from various clinical specimens were identified by standard mycological techniques and further subjected to SDS-PAGE. Molecular weights were calculated with reference to the marker and dendrograms were prepared using the SPSS software. Susceptibility testing of five antifungal agents (fluconazole, clotrimazole, nystatin, amphotericin-B and voriconazole) was done by the disc diffusion/colorimetric microdilution method. On cluster analysis, six types of banding patterns were observed. Maximum resistance (19.8%) was observed against fluconazole. On analysis of the dendrogram cluster groups, the fluconazole-resistant isolates of C. albicans formed a separate cluster distinct from those of the fluconazole-sensitive isolates. It was also observed that the specimens from a common site tended to fall close together in the dendrogram pattern. Significantly, high frequency of fluconazole resistance was noticed in this study, which is alarming. In resource-limited laboratories, SDS-PAGE could be used as an alternative method for typing.