Candida is the most prevalent fungal bloodstream infection (BSI) with a high mortality rate among
hospitalized patients. Another concern facing physicians is rising global incidence of drug-resistant
Candida. This study aimed to characterize the prevalence, antifungal susceptibility, bioflm formation,
and virulence genes (HWP1, ALS1, SAP2) of diferent Candida spp. isolated from patients with
candidemia. 52 isolates of Candida spp. were identifed from blood cultures by chromogenic Candida
agar and confrmed by the VITEK 2 system. Isolates were tested for antifungal susceptibility by disk
difusion and VITEK 2 system. Bioflm formation and investigated genes were detected by the Congo
red method and conventional PCR, respectively. Candida spp. caused 2.3% of detected BSIs, of which
32.7% were caused by Candida albicans (C. albicans) and 67.3% by non-albicans Candida (NAC), with
the predominance of C. tropicalis (25%), followed by C. parapsilosis (17.3%), and C. krusei (13.5%).
The susceptibility rates to fuconazole, voriconazole, caspofungin, micafungin, amphotericin B, and
fucytosine were 64.7%, 76.5%, 100.0%, 100%, 100.0%, and 100.0% in C. albicans, while 53.6%,
71.4%, 91.4%, 91.4%, 94.3%, and 94.3% in NAC, respectively. Bioflm production, HWP1, ALS1, and
SAP2 were detected in 70.6%, 82.4%, 76.5%, and 52.9% of C. albicans and 74.3%, 85.7%, 80.0%,
and 48.6% of NAC, respectively. There is remarkable shift to NAC BSIs and high azole resistance.
Antifungal stewardship and analysis of risk factors associated with this shift are needed. |
