Prevalence and Antifungal Susceptibility of Clinically Relevant Candida Species, Identification of Candida auris and Kodamaea ohmeri in Bangladesh

Abstract

<i>Candida</i> species are major fungal pathogens in humans. The aim of this study was to determine the prevalence of individual <i>Candida</i> species and their susceptibility to antifungal drugs among clinical isolates in a tertiary care hospital in Bangladesh. During a 10-month period in 2021, high vaginal swabs (HVSs), blood, and aural swabs were collected from 360 patients. From these specimens, <i>Candida</i> spp. was isolated from cultures on Sabouraud dextrose agar media, and phenotypic and genetic analyses were performed. A total of 109 isolates were recovered, and <i>C. albicans</i> accounted for 37%, being derived mostly from HVSs. Among non-albicans <i>Candida</i> (NAC), <i>C. parapsilosis</i> was the most frequent, followed by <i>C. ciferrii</i>, <i>C. tropicalis</i>, and <i>C. glabrata</i>. Three isolates from blood and two isolates from aural discharge were genetically identified as <i>C. auris</i> and <i>Kodamaea ohmeri</i>, respectively. NAC isolates were more resistant to fluconazole (overall rate, 29%) than <i>C. albicans</i> (10%). <i>Candida</i> isolates from blood showed 95% susceptibility to voriconazole and less susceptibility to fluconazole (67%). Two or three amino acid substitutions were detected in the <i>ERG11</i> of two fluconazole-resistant <i>C. albicans</i> isolates. The present study is the first to reveal the prevalence of <i>Candida</i> species and their antifungal susceptibility in Bangladesh.