Abstract

Abstract
Objectives: To study the antifungal susceptibility and biofilm forming ability of Candida species isolated from various clinical samples.
Methods: 123 isolates of candida species from recovered from clinical specimens like vaginal discharge, blood, urine, pus, body fluids, sputum were included in the study. The identification was done by standard methods by isolating in SDA followed by Germ tube test, Chromagar candida, Corn meal agar and Vitek YST cards. Antifungal susceptibility testing was done by disc diffusion method12. Biofilm formation was detected by tissue culture plate method13. Results are summarized as frequency tables, and percentages and Statistical analysis was done by SPSS 16.0 software.
Results: In the present study, 123 Candida spp. were isolated from different clinical samples, which included C. albicans (51.2%) followed by C. tropicalis (24.3%), C. glabrata (9.75%), C. krusei (7.3%), and C. parapsilosis (7.3%). Candida albicans was the predominant isolate among all species of Candida. Out of 63 Candida albicans isolates, 24 (38%) strains were positive for biofilm production. Among the total 60 non-Candida albicans, 39 (65%) isolates were biofilm producers. Antifungal susceptibility testing of various Candida species showed 
that all isolates were susceptible to amphotericin. 75.55% strains were sensitive to fluconazole. 18.88% of the Candida spp. were resistant to voriconazole. Out of 63 Candida albicans isolates, 24 (38%) strains were positive for biofilm production. Among the total 60 non-Candida albicans, 39 (65%) isolates were biofilm producers.
Conclusion: Candida albicans was the most commonly isolated species identified but non Albicans Candida species as a whole were the predominant group. Candida strains isolated in our study area have not yet developed resistance to amphotericin B. The possibility of reduced susceptibility to fluconazole and voriconazole may be due to widespread and long-term use of those antifungals among the study subjects. Our study underlines the importance of performing identification of Candida species and antifungal susceptibility test to guide treatment and prevent development of antifungal drug resistance. Biofilm formation is another important virulence determinant which can lead to chronic and persistent infections. There is no statistical correlation between the biofilm formation and antifungal susceptibility (p>0.05).