title: Emergence of nonalbicans Candida in neonatal septicemia and antifungal susceptibility: experience from a tertiary care center.
abstract: OBJECTIVE
  To know the distribution and antifungal susceptibility pattern of Candida species in neonatal septicemia cases.
  
  
  METHODS
  In a prospective analysis blood samples from 825 clinically suspected cases of neonatal septicemia, collected aseptically, were cultured to look for the role of Candida spp. in septicemia. Candida isolates were speciated by germ tube test, Hi-CHROME agar, sugar fermentation, and sugar assimilation tests using standard protocol. All the Candida isolates were tested for antifungal susceptibility to fluconazole by the Disk Diffusion (DD) method and broth micro dilution-minimum inhibitory concentration (BMD-MIC) method using NCCLS guidelines.
  
  
  RESULTS
  Isolation rate of Candida from neonatal septicemia cases was 8.1%. Most common isolate was C. tropicalis (61.19%), followed by C. albicans (19.40%), C. glabrata (11.94%), C. parapsilosis (5.97%) and C. guillermondii (1.49%). Low birth weight and previous antibiotic prophylaxis was found in 100% cases. Crude mortality rate was 50.1%. By DD method, 95.53% of the Candida isolates were sensitive to fluconazole. A discrepancy between DD method and BMD-MIC method was noted in 4.47% strains. One isolates each of C. tropicalis, C. albicans, and C. glabrata showed discrepancy.
  
  
  CONCLUSIONS
  Nonalbicans Candida has emerged as an important cause of neonatal septicemia. Routine susceptibility testing of Candida isolates by DD method should be confirmed by BMD-MIC method. Fluconazole can be used as empirical therapy for neonatal candidemia at our center.
authors.affiliation: Department of Microbiology, Pt. B.D.S. PGIMS, Rohtak, India.
authors.forename: Nidhi
authors.initials: N
authors.lastname: Goel
authors.forename: Prabhat K
authors.initials: PK
authors.lastname: Ranjan
authors.forename: Ritu
authors.initials: R
authors.lastname: Aggarwal
authors.forename: Uma
authors.initials: U
authors.lastname: Chaudhary
authors.forename: Nanda
authors.initials: N
authors.lastname: Sanjeev