Distribution and Antifungal Susceptibility of Candida Species Isolated from Blood Cultures

Abstract

Objective: Candidemia is defined as the isolation of Candida species from blood and is an infection with high mortality and morbidity. Although Candida albicans is the most common causative agent of candidemia in blood cultures, the detection rate of non-albicans species in blood has increased in recent years. In this study, the aim was to determine the distribution and antifungal susceptibility patterns of Candida species isolated from blood cultures.

Methods: Candida species isolated from blood culture specimens received by the microbiology laboratory of the hospital between 2021 and 2023 were retrospectively analyzed. Species identification and antifungal susceptibility tests of Candida isolates were performed on the VITEK 2 automated system.

Results: Candidemia was detected in 123 different patients over a 3-year period and 132 Candida species isolated from these patients were included in the study. Of the 132 isolates, 88% belonged to patients hospitalized in the intensive care unit and 12% belonged to patients hospitalized in the other clinics. At the species level, Candida albicans was isolated 39.4%, Candida parapsilosis 30.3%, Candida glabrata 12.1%, Candida tropicalis 11.3%. The highest susceptibility rate was 98.4% to micafungin, while susceptibility rates for other antifungals were 97.6%, 97.2%, 94.4%, and 88.3% to caspofungin, voriconazole, amphotericin B, and fluconazole, respectively. Susceptibility rates were found to decrease in all other antifungals except amphotericin B in 2023 compared to 2021. This decrease in fluconazole was found to be statistically significant.

Conclusion: Candidemia is a clinical condition with high mortality and requires rapid diagnosis. In this study, it was found that C. albicans was most frequently isolated as the causative agent of candidemia, however, non-albicans Candida species were also important pathogens of candidemia and antifungal susceptibility rates decreased over the years. Therefore, it is important for each center to determine its own candidemia agent distribution and antifungal susceptibility pattern.

Cite this article as: Yılmaz Yücel F, Duran H. Distribution and antifungal susceptibility of Candida species isolated from blood cultures. Cerrahpaşa Med J. 2025, 49, 0036, doi:10.5152/cjm.2025.25036.