Epidemiology and antifungal susceptibility patterns of invasive candidiasis: A single-center study

Abstract

Background: Invasive candidiasis remains a leading cause of morbidity and mortality. Despite the availability of various antifungal treatments, global reports continue to highlight resistance, treatment ineffectiveness, and outbreaks. This study aimed to analyze the epidemiology of various Candida species isolated from invasive samples and assess their antifungal susceptibility profiles. Material and Methods: The study identified and evaluated a total of 200 Candida isolates, recovered over a 6-month period from various clinical specimens. These were assessed against various antifungals according to recommendations. Results: Among the samples, blood (79%) and pus (12%) were the most commonly encountered sources of Candida isolation. Candida isolates comprised 14.5% (30) C. albicans and 85.5% (170) non-albicans species. Non-albicans species included 15% (30) C. guilliermondii, 14.5% (29) C. lusitaniae, 11.5% (22) C. tropicalis, 2.3% (4) C. auris, and 8.5% (17) C. parapsilosis. Overall, the strains showed 74% and 91% sensitivity to Fluconazole and Voriconazole, respectively, and 100% sensitivity to Caspofungin and Amphotericin B, with the exception of C. lusitaniae. Conclusion: The susceptibility profile of antifungals is evolving. This study demonstrated a low rate of resistance to four antifungals in invasive candidiasis in Pakistan. None of the isolates were resistant to more than one drug. Early and prompt treatment through the implementation of an antifungal stewardship program and strict infection control is crucial. Keywords: Invasive candidiasis (IC), Antifungal susceptibility profile, Fluconazole, Candidemia