Correlation Of Biofilm Production Of Candida Species With Candida Score- A Futuristic Tool For Assessing Invasive Candidiasis

Abstract

Introduction:Invasive Candidiasis is associated with higher mortality rates. It may be due to multifocal colonization with more virulent and resistant Candida species. “Candida score” is a bedside scoring system to assess invasiveness and to start antifungal therapy early.Aim and objectives:The aim of this study is to determine biofilm formation of multidrug resistant Candida species isolated from patients with nosocomial invasive Candidiasis and its correlation with calculated Candida score of those cases.Materials and methods:Candida species were isolated and identified along with their antifungal susceptibility from blood cultures collected from critically ill patients having Candida associated blood stream infections. Biofilm production of those species was also examined. Candida score of those patients was calculated and it was correlated with biofilm productions.Results:A total of 150 critically ill cases were diagnosed as invasive Candidiasis and diagnosed Candidaemia microbiologically based on blood culture positivity or during their stay in ICU. Most of the patients in this study group were male (62.67%) than female (37.33 %) with male: female ratio being 1.68:1. 0-10 years of age group was more commonly (65.33%) affected, followed by age group >50 years (22%). 55 isolates (36.67%) were C. albicans and 95 (63.33%) were NAC species. Out of NAC species, 32 (21.33%) were C. tropicalis, 18 (12%) C. glabrata, 19 (12.67%) C. guilliermondii, 16 (10.67%) C. parapsilosis and 10 (6.67%) C. auris.93 (62%)  Candida isolates produced biofilm, out of which 37 (39.78%) were C. albicans and 56 (60.22%) were NAC species. Fluconazole was most resistant antifungal (46%) among the isolated Candida species. Cases with Candida score ≥3 were 68 (45.33%). Correlation between biofilm production and Candida score (invasiveness) was found to be strongly statistically significant.Conclusion:Higher Candida score points towards more virulent and resistant invasive Candidiasis with higher mortality rates, thus necessitating early and prompt anti-fungal therapy to reduce morbidity and mortality

Keywords: Candida Score, Biofilm, Virulent, Resistant