title: Ocular infections caused by Candida species: Type of species, in vitro susceptibility and treatment outcome.
abstract: OBJECTIVE
  To report clinical and microbiological profile of patients with ocular candidiasis.
  
  
  METHODS
  Patients with ocular candidiasis were retrospectively identified from microbiology records. Significant isolates of Candida species were identified by Vitek 2 compact system. Minimum inhibitory concentration (MIC) of antifungal agents such as amphotericin B, itraconazole, voriconazole, fluconazole and caspofungin was determined by E test and of natamycin by microbroth dilution assay. Data on treatment and outcome were collected from medical records.
  
  
  RESULTS
  A total of 42 isolates of Candida were isolated from patients with keratitis-29, endophthalmitis-12 and orbital cellulitis-1. The most common species isolated was Candida albicans (12-keratitis, 4-endophthalmitis, 1-orbital cellulitis). All except one isolate were susceptible to amphotericin B. MIC of caspofungin was in the susceptible range in 28 (96.5%) corneal isolates while 12 out of 29 (41.3%) corneal isolates were sensitive to fluconazole. Resistance to voriconazole was seen in four corneal isolates. All isolates were susceptible to natamycin and all except two isolates were resistant or susceptible dose-dependent to itraconazole. Outcome of healed ulcer was achieved in 12/18 (66.6%) patients treated medically, while surgical intervention was required in 11 patients. Among the isolates from endophthalmitis patients, 11/12 were susceptible to amphotericin B, 6/12 to voriconazole and all to natamycin. Ten out of 11 patients (one patient required evisceration) with endophthalmitis were given intravitreal amphotericin B injection with variable outcome.
  
  
  CONCLUSIONS
  Ocular candidiasis needs early and specific treatment for optimal results. Candida species continue to be susceptible to most commonly available antifungals including amphotericin B, voriconazole and natamycin.
authors.forename: S R
authors.initials: SR
authors.lastname: Motukupally
authors.forename: V R
authors.initials: VR
authors.lastname: Nanapur
authors.forename: K N
authors.initials: KN
authors.lastname: Chathoth
authors.forename: S I
authors.initials: SI
authors.lastname: Murthy
authors.forename: R R
authors.initials: RR
authors.lastname: Pappuru
authors.forename: A
authors.initials: A
authors.lastname: Mallick
authors.affiliation: Jhaveri Microbiology Centre, Lakshmi Vara Prasad Eye Institute, Hyderabad, Telangana, India.
authors.forename: S
authors.initials: S
authors.lastname: Sharma
mesh_terms: D000935:Antifungal Agents / Q000494:pharmacology* / Q000627:therapeutic use*; D002175:Candida / Q000145:classification* / Q000187:drug effects* / Q000302:isolation & purification; D002177:Candidiasis / Q000188:drug therapy / Q000382:microbiology*; D015817:Eye Infections / Q000188:drug therapy / Q000382:microbiology*; D006801:Humans; D008826:Microbial Sensitivity Tests; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000935:Antifungal Agents