Haematogenous Spread of Fluconazole Resistant Candida Tropicalis from Mycobiome of Respiratory Tract in COPD Patients

The association between candidaemia and particularly the drug resistant candidaemia with COPD is largely unknown, although COPD patients with drug resistant candidaemia show very high mortality rate. Thus in this study we aimed to find whether there is a significant association between COPD and drug resistant Candida tropicalis isolated from blood and sputum from such cases as this species is now commonly isolated from blood. After isolation of the C. tropicalis from blood fluconazole resistance was confirmed by broth dilution technique following CLSI guidelines and then association with COPD was statistically analyzed. Fluconazole resistant C. tropicalis in blood was 53.3% in patients with COPD, while it was only 12.5% in patients without COPD. Similarly in the sputum fluconazole resistant C. tropicalis was 100% in COPD cases while they were only 33.3% in non-COPD cases. Although recently there is development of many newer antifungal agents but the mortality due to candidaemia still remains very high particularly in COPD patients. Thus early initiation of the proper antifungal treatment is essential in such cases.