Association of Candida and its antifungal susceptibility pattern in patients with pulmonary tuberculosis

Aim: The purpose of this study was to determine the incidence of Candida species and antifungal susceptibility pattern among smear positive pulmonary tuberculosis patients in a coastal tertiary care teaching hospital. Materials and Method: One hundred and twenty one sputum samples were found to be positive for acid fast bacilli by Ziehl-Neelsen stain. All positive sputum samples were taken into consideration and subjected to standard mycological procedures. Results: Out of 121 patients sputum samples positive for acid fast bacilli, Candida co infection was revealed in 41 samples(33.89%). Candida albicans was the most common species isolated and accounted for 60.98% followed by C.tropicalis(21.95%), C.krusei(9.76%) and C.glabrata(7.31%). Out of 539 AFB negative sputum samples, 107(19.85%) samples yielded the growth of Candida. Candida albicans 69 (64.49%) was the most commonest species followed by Candida tropicalis 35(32.71%). Majority of C.albicans and C.tropicalis were showed resistance to azole group. Only 52% of susceptibility exhibited towards fluconazole and clotrimazole by Candida albicans. Susceptibility of C.tropicalis towards fluconazole(55%) and clotrimazole(33%) was also high. All strains of C.krusie and C.glabrata were showed susceptibility to azole group as well as amphotericin B. Few strains of C.albicans(12%) and C.tropical(12%) were shown resistance to amphotericin B. Conclusion: Candida co infection was found in 33.8% of 121 AFB proven pulmonary tubedrculosis patients. Antifungal susceptibility testing revealed resistance to tested azole drugs as well as to amphtericin B. Hence there is a need to perform the Antifungal susceptibility testing before administering antifungals.