Species Distribution of Candida Isolates in Amniotic Fluid, Vaginal Discharge, and Lochial Cultures in Obstetric and Gynecological Patients: A Retrospective Single-Center Study.

(1) Background: Candida-positive cultures in pregnancy and the postpartum period are frequently identified in obstetric and gynecological practice. This study evaluated species distribution and associated maternal and obstetric variables in amniotic fluid, vaginal discharge, and lochial cultures. (2) Methods: A retrospective, single-center, cross-sectional comparative study was conducted at the "Cuza Vodă" Clinical Hospital of Obstetrics and Gynecology, Iași, including Candida-positive samples collected in 2024 (242 amniotic fluid, 2020 vaginal discharge, and 827 lochial isolates). Fungal identification was performed using Sabouraud and chromogenic media, with species-level identification in most cases and classification as Candida spp. when differentiation was not possible. (3) Results: Candida albicans predominated across all compartments (69.8%, 55.3%, and 66.9%, respectively), followed by non-albicans species, mainly Pichia kudriavzevii. Vaginal discharge cultures, obtained from both pregnant and non-pregnant women and analyzed after stratification by pregnancy status, showed multiple significant associations with maternal and obstetric variables; apparent associations with fetal variables were largely attributable to the inclusion of non-pregnant women and were not retained within the pregnant stratum. Amniotic fluid and lochial cultures demonstrated limited associations. Older maternal age was the only consistent independent correlate of non-albicans Candida isolation, whereas the remaining associated variables were compartment-specific. Multivariable models identified compartment-specific correlates of non-albicans Candida isolation but showed limited discriminatory performance, with low sensitivity in most strata. (4) Conclusions: Candida species distribution is compartment-dependent, with greater clinical heterogeneity in vaginal discharge and more limited patterns in amniotic fluid and lochia. These culture-positive findings support species-level identification for microbiological surveillance and provide perinatal microbiological context for future integrated maternal-neonatal studies; because antifungal susceptibility and neonatal outcomes were not assessed, no therapeutic or neonatal inferences can be drawn.