title: Studying the Prevalence, Species Distribution, and Detection ofIn vitroProduction of Phospholipase fromCandidaIsolated from Cases of Invasive Candidiasis.
abstract: OBJECTIVE
  Candidaspp. have emerged as successful pathogens both in invasive and mucosal infections.C. albicansis the sixth cause of most common nosocomial infections according to studies by the Centers for Disease Control and Prevention. A shift toward non-albicans species has been reported. There is a dearth of knowledge regarding the virulence factors ofCandida, especially from this part of India. The aim was to study the prevalence ofCandida, speciate, and determine antifungal sensitivity along with the detection ofin vitroproduction of phospholipases in 100Candidaisolates.
  
  
  METHODS
  A total of 100Candidaisolates from various clinical specimens were studied (February 1, 2015-May 31, 2015; 4 months). Speciation was done by conventional methods and antifungal drugs fluconazole and voriconazole tested. Phospholipase activity (Pz value) was determined.
  
  
  RESULTS
  Of the 100Candidaspp., 35% wereC. albicansand 65% were nonalbicansCandida(NAC). Species spectrum was of the 100 isolates as follows: 35 wereC. albicans, 17Candida tropicalis, 6Candida glabrata, 8Candida guilliermondi, 1Candida kefyr, 6Candida krusei, 14Candida parapsilosis, 2Candida lusitaniae, and 1Trichosporonand 10Candidaspp. (not speciated). Phospholipase production was seen in 81 (81%) of the total isolates. The majority (63%) of phospholipase producers were NAC. Among NAC spp., the maximum phospholipase activity was seen inC. tropicalis(30%) andC. parapsilosis(24%). Of these, 60% ofCandidawas from patients admitted to the hospital. Sensitivity rates ofC. albicansfor fluconazole and voriconazole were 89.5% and 90.5%, respectively.
  
  
  CONCLUSIONS
  Increasing usage of devices, total parenteral nutrition, broad-spectrum antibiotics, chemotherapies, and transplantation are factors contributing to the increase of candidal infections. Recent studies underline the increasing frequency of infections by NAC. The present study showcases the increased prevalence as well as virulence of NAC. In addition, early detection of virulence factors byCandidais useful in clinical decision-making.
authors.affiliation: Department of Microbiology, Laboratory Diagnostic Services, St. Stephen's Hospital, New Delhi, India.
authors.forename: Yukti
authors.initials: Y
authors.lastname: Sharma
authors.affiliation: Department of Microbiology, Laboratory Diagnostic Services, St. Stephen's Hospital, New Delhi, India.
authors.forename: Susheel Kumar
authors.initials: SK
authors.lastname: Chumber
authors.affiliation: Department of Hematology, Laboratory Diagnostic Services, St. Stephen's Hospital, New Delhi, India.
authors.forename: Mandeep
authors.initials: M
authors.lastname: Kaur
keywords: Candida; phospholipase activity; virulence