Antibiotics (Basel, Switzerland) · 2026
Shifting Epidemiology and Antifungal Susceptibility Patterns of Clinical Fungal Isolates in an Intensive Care Unit (ICU) from Bucharest, Romania: A Retrospective Observational Study.
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Solomon Madalina Preda, Mahler Beatrice, Popescu Oana, Ditu Lia-Mara, Gheorghe-Barbu Irina, Chivu Laura Ioana, Manolescu Loredana Sabina Cornelia
Аннотация
BACKGROUND: Antifungal resistance among Candida species represents a growing clinical challenge, particularly in the context of increasing prevalence of non-albicans species.
METHODS: We conducted a retrospective analysis of 747 fungal isolates collected between 2021 and 2026, evaluating species distribution, antifungal susceptibility profiles, minimum inhibitory concentration (MIC) patterns, and temporal trends in resistance.
RESULTS: Non-albicans Candida species accounted for 67.5% of isolates, exceeding the proportion of Candida albicans. Fluconazole and flucytosine exhibited the highest resistance rates (16.1% and 17.4%, respectively), while amphotericin B showed the highest susceptibility rate (82.1%). MIC analysis revealed elevated MIC90 values for azoles in Candida glabrata and Candida krusei, consistent with reduced susceptibility. A significant association between antifungal agent and susceptibility profile was observed (χ2 = 33.81, p < 0.001; Cramér's V = 0.205). Temporal analysis demonstrated fluctuating resistance patterns rather than a consistent increase over time. Multidrug resistance was uncommon (2.5%), although non-susceptibility to multiple agents was more frequent (20.3%).
CONCLUSIONS: The study highlights substantial variability in antifungal susceptibility across Candida species and antifungal agents, emphasizing the importance of continuous surveillance and species-specific treatment strategies.
METHODS: We conducted a retrospective analysis of 747 fungal isolates collected between 2021 and 2026, evaluating species distribution, antifungal susceptibility profiles, minimum inhibitory concentration (MIC) patterns, and temporal trends in resistance.
RESULTS: Non-albicans Candida species accounted for 67.5% of isolates, exceeding the proportion of Candida albicans. Fluconazole and flucytosine exhibited the highest resistance rates (16.1% and 17.4%, respectively), while amphotericin B showed the highest susceptibility rate (82.1%). MIC analysis revealed elevated MIC90 values for azoles in Candida glabrata and Candida krusei, consistent with reduced susceptibility. A significant association between antifungal agent and susceptibility profile was observed (χ2 = 33.81, p < 0.001; Cramér's V = 0.205). Temporal analysis demonstrated fluctuating resistance patterns rather than a consistent increase over time. Multidrug resistance was uncommon (2.5%), although non-susceptibility to multiple agents was more frequent (20.3%).
CONCLUSIONS: The study highlights substantial variability in antifungal susceptibility across Candida species and antifungal agents, emphasizing the importance of continuous surveillance and species-specific treatment strategies.