Caspofungin MIC Distribution amongst Commonly Isolated Candida Species in a Tertiary Care Centre - An Indian Experience

Introduction: Emergence of Candida species resistant to Amphotericin B and triazole has led to use of echinocandins, mostly caspofungin in the management of invasive candidiasis. There are some published reports of caspofungin resistance in Candida species yet no studies on caspofungin susceptibility pattern of Candida species exist in Indian setup. Aim: To carry out the antifungal susceptibility of Candida isolates against caspofungin. Materials and Methods: In a retrospective study at a tertiary care teaching hospital, 60 preserved Candida isolates from inpatients of invasive candidiasis obtained over a period of 6 months from January 2015 to June 2015 were subjected to antifungal susceptibility to caspofungin and the Minimum Inhibitory Concentrations (MICs) of Candida species to caspofungin were determined by Epsilometer test (E-test). Results: Thirty Candida albicans and 30 Non albicans Candida mainly Candida glabrata, Candida parapsilosis and Candida tropicalis were tested for caspofungin susceptibitity by E-test. Caspofungin resistance was detected in 6.67% Candida albicans isolates. Caspofungin resistance was not observed in Candida parapsilosis, Candida glabrata and Candida tropicalis. This shows that caspofungin resistance is still rare. Further elaborate studies with clinical correlation data are needed to detect prevalence of caspofungin resistance. Conclusion: Emergence of resistance in our study warrants need of elaborate studies with clinical correlation data to detect prevalence of resistance to caspofungin. E-test method proved to be an easy and simple technique for testing susceptibility of Candida to caspofungin.