COMPARATIVE ASSESSMENT OF CANDIDA SPP. SUSCEPTIBILITY AND RESISTANCE TO ANTIFUNGAL AGENTS BY BIOLOGICAL MATERIAL TYPE
Background: Invasive fungal infections caused by Candida species remain a significant global health concern, particularly in immunocompromised individuals. Effective treatment requires precise knowledge of antifungal susceptibility patterns, which may vary depending on the biological source of isolation.
Objective: This study aims to evaluate and compare the susceptibility and resistance profiles of Candida spp. to five major antifungal agents across different types of biological materials providing clinically relevant insights for antifungal stewardship and infectious disease management.
Materials and Methods: A retrospective, observational, and descriptive study was conducted using 1,220 clinical isolates of Candida spp., collected from sputum (n=893), ENT organs (n=277), and cerebrospinal canal (n=50). Identification was carried out using conventional culture and microscopy. Susceptibility to anidulafungin, micafungin, voriconazole, caspofungin, and fluconazole was assessed using the broth microdilution method according to CLSI M27 and EUCAST guidelines. Minimum inhibitory concentrations (MICs) were used to determine susceptibility and resistance. Data analysis was performed using Microsoft Excel and IBM SPSS Statistics.
Results: Fluconazole demonstrated the highest overall susceptibility across all specimen types, especially in cerebrospinal canal isolates (80.0%) and sputum (78.6%). Among echinocandins, anidulafungin and micafungin showed strong activity, particularly in CNS and respiratory isolates. Voriconazole consistently exhibited the lowest susceptibility and highest resistance, especially in ENT-derived samples. Caspofungin presented moderate efficacy with variable resistance patterns. Resistance was highest in voriconazole (up to 40.4% in ENT samples), followed by caspofungin and micafungin. Fluconazole had the lowest resistance across all groups.
Conclusion: The effectiveness of antifungal drugs varies by the source of Candida spp. Fluconazole was most effective, especially in CNS infections. Voriconazole showed lower efficacy and more resistance. Treatment should be based on infection source to improve outcomes and reduce resistance.
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Mukasheva G.D., Maukayeva S.B., Kudaibergenova N.K., Lepesbayev M.N., Smailova Zh.K., Orazalina A.S., Kozhanova S.K., Mukanova D.А., Apbassova S.A., Rakhimzhanova F.S. Comparative assessment of Candida spp. Susceptibility and resistance to antifungal agents by biological material type // Nauka i Zdravookhranenie [Science & Healthcare]. 2025. Vol.27 (5), pp. 95-102. doi 10.34689/SH.2025.27.5.012Related publications:
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